Organization
BEACON PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYUR PATEL (MEMBER)
(845) 292-8200
Entity
Organization
Contact information
Practice address
42 WINDSOR AVE, VERNON, CT 06066-2438
(860) 875-9263
Mailing address
42 WINDSOR AVE, VERNON, CT 06066-2438
(860) 875-9263
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008043533
—
CT
Enumeration date
12/19/2019
Last updated
12/19/2019
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