Provider Demographics
NPI:1831317031
Name:LEAR PHARMACY
Entity Type:Organization
Organization Name:LEAR PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RADIN
Authorized Official - Suffix:
Authorized Official - Credentials:REG PHARMACY
Authorized Official - Phone:203-735-7433
Mailing Address - Street 1:198 WAKELEE AVE
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1153
Mailing Address - Country:US
Mailing Address - Phone:203-735-7433
Mailing Address - Fax:203-736-6256
Practice Address - Street 1:198 WAKELEE AVE
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1153
Practice Address - Country:US
Practice Address - Phone:203-735-7433
Practice Address - Fax:203-736-6256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0702793OtherNABP