Provider Demographics
NPI:1154569481
Name:COLUMBUS CHEMISTS LLC
Entity type:Organization
Organization Name:COLUMBUS CHEMISTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:VIPPARLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-785-9001
Mailing Address - Street 1:615 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-2112
Mailing Address - Country:US
Mailing Address - Phone:203-562-4447
Mailing Address - Fax:203-562-4448
Practice Address - Street 1:615 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-2112
Practice Address - Country:US
Practice Address - Phone:203-562-4447
Practice Address - Fax:203-562-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCY2133332B00000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6493330001Medicare NSC