Organization
MEDSTAT PHARMACY LLC
Active
Other names
Medstat Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD PELC (VP OPERATIONS)
(413) 374-9210
Entity
Organization
Contact information
Practice address
41 NORTHWEST DR, PLAINVILLE, CT 06062-1234
(860) 677-2934
Mailing address
41 NORTHWEST DR, PLAINVILLE, CT 06062-1234
(860) 677-2934
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
0002207
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0722341
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/01/2011
Last updated
02/24/2012
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