Whalio Doctors

NPI 1164587580

Bonneville Rx LLC

Organisation Community/Retail Pharmacy Danielson, CT

Practice location

Address
77 Westcott Rd, Danielson, CT 06239-2929
Phone
(860) 774-9362
Fax
(860) 779-2647

Authorised official

Name
Ravinder Annamaneni
Title
Member
Phone
(860) 774-9362

Registered specialties

Community/Retail Pharmacy Primary
Suppliers Taxonomy 3336C0003X Licence PCY0000159 (CT)

Registry record

NPI
1164587580
Entity type
Organization
NPI issued
26 Dec 2006
Record last updated
9 Sep 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.