Provider Demographics
NPI:1992189146
Name:WASSEF LLC
Entity Type:Organization
Organization Name:WASSEF LLC
Other - Org Name:THE MEDICINE SHOPPE 2024
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAGY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSEF
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:860-449-3097
Mailing Address - Street 1:535 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1506
Mailing Address - Country:US
Mailing Address - Phone:860-449-3097
Mailing Address - Fax:860-442-4513
Practice Address - Street 1:535 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1506
Practice Address - Country:US
Practice Address - Phone:860-449-3097
Practice Address - Fax:860-442-4513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy