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Organization

HANCOCK PHARMACY V LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SUDHEER GHANTA (MEMBER / SP)
(860) 346-9700
Entity
Organization

Contact information

Practice address
644 MAIN ST, MIDDLETOWN, CT 06457-2731
(860) 346-9700
(860) 346-9702
Mailing address
644 MAIN ST, MIDDLETOWN, CT 06457-2731
(860) 346-9700
(860) 346-9702

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY0002177
CT
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0002177
CT

Other

Enumeration date
04/29/2010
Last updated
07/29/2014
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