Organization
BORDONARO'S PHARMACY INC.
Active
Other names
THE MEDICINE CENTRE BORDONARO'S
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH E BORDONARO RPH (OWNER MANAGER)
(860) 342-3390
Entity
Organization
Contact information
Practice address
283 MAIN ST, PORTLAND, CT 06480-1856
(860) 342-3390
(860) 342-3391
Mailing address
283 MAIN ST, PORTLAND, CT 06480-1856
(860) 342-3390
(860) 342-3391
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
752
CT
3336C0003X
Community/Retail Pharmacy
Primary
752
CT
3336C0004X
Compounding Pharmacy
752
CT
3336L0003X
Long Term Care Pharmacy
752
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004018933
MEDICAID DME
CT
05
—
004032512
—
CT
01
—
0701549
NABP
CT
01
—
12DME0003CT01
BLUE CROSS DME
CT
Enumeration date
11/15/2006
Last updated
04/04/2011
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