NPI 1164587580
Bonneville Rx LLC
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
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.