Organization
W.H. PICKETT DRUG CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD STUKSHIS RPH (PRESIDENT)
(203) 753-5158
Entity
Organization
Contact information
Practice address
675 N MAIN ST, WATERBURY, CT 06704-3508
(203) 753-5158
(203) 597-0625
Mailing address
675 N MAIN ST, WATERBURY, CT 06704-3508
(203) 753-5158
(203) 597-0625
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
421
CT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004028148
—
CT
Enumeration date
07/29/2006
Last updated
09/29/2008
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