Organization
NUTMEG PHARMACY MOODUS LLC
Active
Other names
Nutmeg Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY EDWARD MCKENNA RPH (MANAGING MEMBER)
(860) 345-3607
Entity
Organization
Contact information
Practice address
26 FALLS RD, MOODUS, CT 06469-1262
(860) 891-8164
(860) 891-8313
Mailing address
PO BOX 540, HIGGANUM, CT 06441-0540
(860) 345-3607
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008092217
—
CT
Enumeration date
12/03/2019
Last updated
02/07/2023
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