Provider Demographics
NPI:1952031205
Name:TORRINGTON PHARMACY INC
Entity Type:Organization
Organization Name:TORRINGTON PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:PETRICONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:860-489-5511
Mailing Address - Street 1:110 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-5429
Mailing Address - Country:US
Mailing Address - Phone:860-489-5511
Mailing Address - Fax:860-489-2645
Practice Address - Street 1:110 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-5429
Practice Address - Country:US
Practice Address - Phone:860-489-5511
Practice Address - Fax:860-489-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004030284Medicaid