Organization
CANDLEWOOD DRUGS
Active
Other names
CANDLEWOOD DRUGS, candlewood drugs llc
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SIRISHA MALLIDI (PHARMACIST)
(203) 312-9999
Entity
Organization
Contact information
Practice address
11 STATE ROUTE 37, NEW FAIRFIELD, CT 06812-4028
(203) 312-9999
(203) 746-6789
Mailing address
11 STATE ROUTE 37, NEW FAIRFIELD, CT 06812-4028
(203) 312-9999
(203) 746-6789
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0002167
CT
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0002167
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008017664
—
CT
01
—
PCY.0002167
STATE BOARD LICENSE NUMBER
CT
Enumeration date
04/08/2010
Last updated
01/29/2021
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