Organization
MACKENZIES PHARMACY INC
Active
Other names
MACKENZIES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PAT SANTELLA RPH (OWNER MANAGER)
(203) 261-2541
Entity
Organization
Contact information
Practice address
930 WHITE PLAINS RD, TRUMBULL, CT 06611-4550
(203) 261-2541
(203) 268-5836
Mailing address
19 BLACKBERRY RD, TRUMBULL, CT 06611-3981
(203) 261-2541
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
208
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004032504
—
CT
01
—
0709785
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2005
Last updated
05/15/2013
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