Provider Demographics
NPI:1366549669
Name:STORRS DRUG,INC
Entity type:Organization
Organization Name:STORRS DRUG,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:C.
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FERRERI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:869-429-9365
Mailing Address - Street 1:ROUTE 195
Mailing Address - Street 2:1232 STORRS RD
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06268
Mailing Address - Country:US
Mailing Address - Phone:860-429-9365
Mailing Address - Fax:860-429-0043
Practice Address - Street 1:ROUTE 195
Practice Address - Street 2:1232 STORRS RD
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268
Practice Address - Country:US
Practice Address - Phone:860-429-9365
Practice Address - Fax:860-429-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4844650001Medicare ID - Type Unspecified