Provider Demographics
NPI:1922681758
Name:DAILYMED PHARMACY LLC
Entity Type:Organization
Organization Name:DAILYMED PHARMACY LLC
Other - Org Name:DAILYMED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ILANGO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINNASAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-666-4000
Mailing Address - Street 1:2366 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5339
Mailing Address - Country:US
Mailing Address - Phone:203-666-4000
Mailing Address - Fax:
Practice Address - Street 1:2366 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5339
Practice Address - Country:US
Practice Address - Phone:203-666-4000
Practice Address - Fax:203-666-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy