Provider Demographics
NPI:1881761781
Name:IVERY & DUDLEY INC
Entity type:Organization
Organization Name:IVERY & DUDLEY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH CDE
Authorized Official - Phone:860-738-9116
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:WINSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06098-0745
Mailing Address - Country:US
Mailing Address - Phone:860-373-8911
Mailing Address - Fax:800-856-0221
Practice Address - Street 1:118 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-1713
Practice Address - Country:US
Practice Address - Phone:860-738-9116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy