Organization
GREAT HILLS LLC
Active
Other names
Meriden Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SURESH KURRA (MEMBER)
(203) 906-3993
Entity
Organization
Contact information
Practice address
152 COLONY ST UNIT A, MERIDEN, CT 06451
(203) 634-3000
(203) 634-3001
Mailing address
152 COLONY STREET, UNIT A, MERIDEN, CT 06451
(203) 634-3000
(203) 634-3001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY0002333
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008064627
—
CT
01
—
2158990
PK
—
Enumeration date
03/22/2016
Last updated
05/03/2017
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