Provider Demographics
NPI:1851391452
Name:IVERY & DUDLEY PHARMACY INC
Entity Type:Organization
Organization Name:IVERY & DUDLEY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:860-379-0755
Mailing Address - Street 1:118 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06098-1713
Mailing Address - Country:US
Mailing Address - Phone:860-379-0755
Mailing Address - Fax:860-379-3742
Practice Address - Street 1:118 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-1713
Practice Address - Country:US
Practice Address - Phone:860-379-0755
Practice Address - Fax:860-379-3742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty