Provider Demographics
NPI:1578147864
Name:ANCHOR HEALTH INITIATIVE CORP.
Entity Type:Organization
Organization Name:ANCHOR HEALTH INITIATIVE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:WALSH
Authorized Official - Last Name:CHADWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-698-0676
Mailing Address - Street 1:30 MYANO LN STE 16
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4532
Mailing Address - Country:US
Mailing Address - Phone:203-321-5671
Mailing Address - Fax:
Practice Address - Street 1:30 MYANO LN STE 16
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4532
Practice Address - Country:US
Practice Address - Phone:203-674-1102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCHOR HEALTH INITIATIVE CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy