Organization
GRAEBER'S PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER C DEZINNO (VP)
(203) 235-6305
Entity
Organization
Contact information
Practice address
172 W MAIN ST, MERIDEN, CT 06451-4104
(203) 235-6305
(203) 235-0244
Mailing address
172 W MAIN ST, MERIDEN, CT 06451-4104
(203) 235-6305
(203) 235-0244
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
416
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004016515
—
CT
05
—
004028114
—
CT
Enumeration date
08/03/2006
Last updated
05/05/2020
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