Organization
BELLA VISTA PHARMACY INC
Active
Other names
Bella Vista Pharmacy inc
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER BEAUDOIN (PHARMACY MANAGER)
(860) 921-7210
Entity
Organization
Contact information
Practice address
321 EASTERN ST, NEW HAVEN, CT 06513-2462
(203) 467-1683
(203) 467-5888
Mailing address
321 EASTERN ST, NEW HAVEN, CT 06513-2462
(203) 467-1683
(203) 467-5888
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY0001063
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004031738
—
CT
01
—
1998401
PK
—
Enumeration date
02/07/2007
Last updated
11/24/2023
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