Organization
HIGGANUM PHARMACY LLC
Active
Other names
Nutmeg Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY MCKENNA (MANAGING MEMBER)
(860) 345-3607
Entity
Organization
Contact information
Practice address
23 KILLINGWORTH RD, HIGGANUM, CT 06441-4242
(860) 345-3607
(860) 345-3611
Mailing address
PO BOX 540, HIGGANUM, CT 06441-0540
(860) 345-3607
(860) 345-3611
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0002191
CT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00802487
—
CT
01
—
2126690
PK
—
Enumeration date
09/03/2010
Last updated
02/06/2023
Update your record
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