Organization
WEST HAVEN PHARMACY, LLC
Active
Other names
West Haven Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHANDRA S VIPPARLA (VICE PRESIDENT)
(203) 934-7100
Entity
Organization
Contact information
Practice address
764 CAMPBELL AVE, WEST HAVEN, CT 06516-3786
(203) 974-7100
(203) 974-7103
Mailing address
764 CAMPBELL AVE, UNIT-A, NEW HAVEN, CT 06513
(203) 934-7100
(203) 934-7104
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY2294
CT
3336C0003X
Community/Retail Pharmacy
Primary
2294
CT
Other
Enumeration date
06/02/2014
Last updated
09/16/2020
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