NPI 1174070452

Michael Grant

Organisation Health Maintenance Organization West Simsbury, CT

Practice location

Address: 4 Daden Ln, West Simsbury, CT 06092-2703
Phone: (860) 869-7251
Mailing address: 1492 Highland Ave, Cheshire, CT 06410-1287

Authorised official

Name: Michael K Grant
Title: Pharmacist
Phone: (860) 869-7251

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 00011965 (CT)

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Registry record

NPI: 1174070452
Entity type: Organization
NPI issued: 5 Sep 2016
Record last updated: 5 Sep 2016

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.