Provider Demographics
NPI:1740317437
Name:FORT HILL PHARMACY INC
Entity type:Organization
Organization Name:FORT HILL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MESSINA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:860-445-6431
Mailing Address - Street 1:116 FORT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4335
Mailing Address - Country:US
Mailing Address - Phone:860-445-6431
Mailing Address - Fax:860-446-0530
Practice Address - Street 1:116 FORT HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4335
Practice Address - Country:US
Practice Address - Phone:860-445-6431
Practice Address - Fax:860-446-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0305350001Medicare ID - Type Unspecified