Organization
BRONCHO DOSE LTD
Active
Other names
Compound RX
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WILLIAM LICAMELE PHARM. D. (CHIEF EXECUTIVE OFFICER)
(203) 375-8000
Entity
Organization
Contact information
Practice address
55 ONTARIO ST, STRATFORD, CT 06615-7135
(203) 375-8000
(800) 784-5430
Mailing address
PO BOX 520, SOUTHPORT, CT 06890-0520
(203) 375-8000
(800) 784-5430
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1732
CT
Other
Enumeration date
11/16/2005
Last updated
03/07/2023
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