Provider Demographics
NPI:1558346742
Name:COVEY, JANIS JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:JEAN
Last Name:COVEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-7335
Mailing Address - Country:US
Mailing Address - Phone:203-876-8541
Mailing Address - Fax:
Practice Address - Street 1:179 MAIN ST
Practice Address - Street 2:COMPOUNDED SOLUTIONS IN PHARMACY
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1107
Practice Address - Country:US
Practice Address - Phone:203-268-4964
Practice Address - Fax:203-268-5492
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist