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Organization

MASONIC HEALTHCARE CENTER

Active
Other names
PHARMACY DEPARTMENT
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN G DEFLORIO R.PH. (DIRECTOR OF PHARMACY)
(203) 679-6928
Entity
Organization

Contact information

Practice address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-6928
(203) 679-5970
Mailing address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-6928
(203) 679-5970

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
119-C
CT
3336L0003X
Long Term Care Pharmacy
119C
CT

Other

Enumeration date
06/16/2005
Last updated
03/07/2023
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