Provider Demographics
NPI:1376275206
Name:NORWICH PHARMACY LLC
Entity Type:Organization
Organization Name:NORWICH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-383-2630
Mailing Address - Street 1:77 SALEM TPKE STE 104
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-6483
Mailing Address - Country:US
Mailing Address - Phone:860-383-2630
Mailing Address - Fax:860-383-2635
Practice Address - Street 1:77 SALEM TPKE STE 104
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-6483
Practice Address - Country:US
Practice Address - Phone:347-635-2419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy