Organization
JOLLYS DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GENESIUS RPH (OWNER)
(203) 245-2704
Entity
Organization
Contact information
Practice address
762 BOSTON POST RD, MADISON, CT 06443-3047
(203) 245-2704
(203) 245-9704
Mailing address
PO BOX 151, MADISON, CT 06443-0151
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0725
CT
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704759
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/08/2006
Last updated
09/11/2025
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