Individual
EDWARD HEACOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
99 S CANAAN RD, CANAAN, CT 06018-2502
(860) 824-3822
Mailing address
12 HUNTING RDG, SHARON, CT 06069-2463
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0006283
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022756516
DRIVERS LICENSE
CT
Enumeration date
03/14/2018
Last updated
03/14/2018
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