Provider Demographics
NPI:1336170349
Name:PARTNERS OF CONNECTICUT, LLC
Entity Type:Organization
Organization Name:PARTNERS OF CONNECTICUT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-206-2664
Mailing Address - Street 1:50 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3121
Mailing Address - Country:US
Mailing Address - Phone:908-931-9111
Mailing Address - Fax:908-931-9328
Practice Address - Street 1:6 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-9626
Practice Address - Country:US
Practice Address - Phone:860-623-3000
Practice Address - Fax:860-623-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT24713336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0719685OtherNCPDP
MA0497941Medicaid
CT4239233Medicaid
6309970001Medicare NSC