Organization · Type 2 NPI

Main Street Pharmacy Inc

Community/Retail Pharmacy · Hartford, CT

NPI number 1154895837 Active

Practice location

421 Park St
Hartford, CT 06106-1534

Fax (860) 200-0707

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1154895837
Entity type: Organization (Type 2)
Issued: Jan 16, 2019
Last updated: Aug 27, 2021
Status: Active

Other names

<unavail>
Main Street Pharmacy · doing business as
Main Street Pharmacy · doing business as

Authorized official

Mr. Raveendra Reddy Bommu
President
(203) 919-3124

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1154895837

Main Street Pharmacy Inc's National Provider Identifier is 1154895837, issued on Jan 16, 2019. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Hartford, CT. The record was last updated on Aug 27, 2021.