Organization
MEDICINE CENTRE HOPE STREET LLC
Active
Other names
Connecticut Pharmacy Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY WOLAK (MANAGING MEMBER)
(203) 518-1147
Entity
Organization
Contact information
Practice address
664 MAIN AVE, UNIT B101, NORWALK, CT 06851-1162
(203) 939-1836
(203) 939-1837
Mailing address
10 FAIRFIELD BLVD, UNIT C, WALLINGFORD, CT 06492-5903
(203) 939-1836
(203) 939-1837
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
28RO00114900
NJ
333600000X
Pharmacy
033409
NY
3336C0003X
Community/Retail Pharmacy
NP000838
PA
3336L0003X
Long Term Care Pharmacy
PHN10764
RI
3336M0002X
Mail Order Pharmacy
0214001732
VA
3336M0002X
Mail Order Pharmacy
036.125415
VT
3336M0002X
Mail Order Pharmacy
Primary
PCY0000434
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004249901
—
CT
01
—
2002651
PK
—
Enumeration date
04/13/2006
Last updated
09/19/2025
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