Organization
BRONCHO DOSE LTD
Active
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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