Organization
SBS PHARMACY LLC
Active
Other names
Willimantic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRAHMAJI GAZZARAPU (PHARMACY MANAGER)
(860) 423-9600
Entity
Organization
Contact information
Practice address
972 MAIN ST, WILLIMANTIC, CT 06226-2310
(860) 423-9600
(860) 423-9601
Mailing address
972 MAIN ST, WILLIMANTIC, CT 06226-2310
(860) 423-9600
(860) 423-9601
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY0000070
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008001977
—
CT
01
—
2000115
PK
—
Enumeration date
08/20/2006
Last updated
12/12/2014
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