Organization
JEWETT CITY PHARMACY
Active
Other names
jewett city pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TONY KOMARI RPH (OWNER/PRESIDENT/PIC/AO)
(860) 376-4468
Entity
Organization
Contact information
Practice address
78 MAIN ST, JEWETT CITY, CT 06351-2226
(860) 376-4468
(860) 376-0399
Mailing address
78 MAIN ST, JEWETT CITY, CT 06351-2226
(860) 376-4468
(860) 376-0399
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0000657
CT
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004032751
—
CT
05
—
004167963
—
CT
05
—
004167971
—
CT
01
—
2001749
PK
—
Enumeration date
08/15/2005
Last updated
07/19/2018
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