Provider Demographics
NPI:1992462303
Name:STAMFORD HEALTH PHARMACY LLC
Entity type:Organization
Organization Name:STAMFORD HEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MS
Authorized Official - First Name:SOKHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:203-276-6194
Mailing Address - Street 1:1 HOSPITAL PLZ STE G122
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3602
Mailing Address - Country:US
Mailing Address - Phone:203-276-2350
Mailing Address - Fax:203-276-2354
Practice Address - Street 1:1 HOSPITAL PLZ STE G122
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3602
Practice Address - Country:US
Practice Address - Phone:203-276-2350
Practice Address - Fax:203-276-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy