Provider Demographics
NPI:1942034814
Name:PETRICONE'S APOTHECARY
Entity type:Organization
Organization Name:PETRICONE'S APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-469-5400
Mailing Address - Street 1:4 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-2120
Mailing Address - Country:US
Mailing Address - Phone:860-469-5400
Mailing Address - Fax:
Practice Address - Street 1:4 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06057-2120
Practice Address - Country:US
Practice Address - Phone:860-469-5400
Practice Address - Fax:860-238-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy