Provider Demographics
NPI:1437708708
Name:CLEAN RXEACH LLC
Entity Type:Organization
Organization Name:CLEAN RXEACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AIKATERINI
Authorized Official - Middle Name:
Authorized Official - Last Name:FINETI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-292-0764
Mailing Address - Street 1:340 PRAYER SPRING RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1322
Mailing Address - Country:US
Mailing Address - Phone:214-991-6411
Mailing Address - Fax:214-440-1671
Practice Address - Street 1:1506 POST RD STE 4
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5916
Practice Address - Country:US
Practice Address - Phone:203-292-0764
Practice Address - Fax:214-440-1671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty