Organization
SHORELINE INTEGRATIVE PHARMACY LLC
Active
Other names
SHORELINE INTEGRATIVE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP HEIN (OWNER, MANAGING MEMBER, AO)
(203) 451-8852
Entity
Organization
Contact information
Practice address
1835 POST RD E, WESTPORT, CT 06880-5666
(203) 309-3783
(203) 517-4155
Mailing address
1835 POST RD E STE 1, WESTPORT, CT 06880-5678
(203) 309-3783
(203) 517-4155
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY2342
CT
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166477
PK
—
Enumeration date
12/05/2016
Last updated
06/04/2019
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