Organization
BEACON FALLS PHARMACY, LLC
Active
Other names
BEACON FALLS PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BRADLEY (OWNER)
(203) 729-4567
Entity
Organization
Contact information
Practice address
20 N MAIN ST, BEACON FALLS, CT 06403-1131
(203) 729-4567
(203) 729-4573
Mailing address
PO BOX 218, BEACON FALLS, CT 06403-0218
(203) 729-4567
(203) 729-4573
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY2015
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004253548
—
CT
01
—
2002743
PK
—
Enumeration date
07/14/2006
Last updated
01/18/2017
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