Provider Demographics
NPI:1053832055
Name:HUGHES, ROBERT (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 SAMSON ROCK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3018
Mailing Address - Country:US
Mailing Address - Phone:203-245-7467
Mailing Address - Fax:
Practice Address - Street 1:136 SAMSON ROCK DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3018
Practice Address - Country:US
Practice Address - Phone:203-245-7467
Practice Address - Fax:203-245-7467
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist