Provider Demographics
NPI:1649869348
Name:ADVANTAGE HEALTH PHARMACY LLC
Entity type:Organization
Organization Name:ADVANTAGE HEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:203-927-2321
Mailing Address - Street 1:102 LANES POND RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06472-1124
Mailing Address - Country:US
Mailing Address - Phone:203-927-2321
Mailing Address - Fax:
Practice Address - Street 1:106 SEBETHE DR STE A
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1094
Practice Address - Country:US
Practice Address - Phone:203-927-2321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy