Provider Demographics
NPI:1811418940
Name:KURE RX INC
Entity Type:Organization
Organization Name:KURE RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:AJEGBA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:860-655-1988
Mailing Address - Street 1:27 BEECHER LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3239
Mailing Address - Country:US
Mailing Address - Phone:860-655-1988
Mailing Address - Fax:
Practice Address - Street 1:1156 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-2393
Practice Address - Country:US
Practice Address - Phone:860-206-3890
Practice Address - Fax:860-906-1428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT170623-000314Medicaid