Provider Demographics
NPI:1225150527
Name:HARTFORD HOSPITAL PHARMACY
Entity Type:Organization
Organization Name:HARTFORD HOSPITAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCAMANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-545-2746
Mailing Address - Street 1:80 SEYMOUR ST
Mailing Address - Street 2:PO BOX 5037
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-8000
Mailing Address - Country:US
Mailing Address - Phone:860-545-2156
Mailing Address - Fax:
Practice Address - Street 1:79 RETREAT AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2527
Practice Address - Country:US
Practice Address - Phone:860-545-2156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0046282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
0714267OtherNABP