SAM'S CLUB PHARMACY #10-6636 (Credential# 519234) is licensed (Pharmacy) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2019. The license expiration date date is August 31, 2020. The license status is ACTIVE.
SAM'S CLUB PHARMACY #10-6636 is licensed with the Department of Consumer Protection of Connecticut. The credential number is #PCY.0002129. The credential type is pharmacy. The effective date is September 1, 2019. The expiration date is August 31, 2020. The business address is 3465 Berlin Tpke, Newington, CT 06111-5106. The current status is active.
| Licensee Name | SAM'S CLUB PHARMACY #10-6636 |
| Business Name | SAM'S CLUB PHARMACY #10-6636 |
| Credential ID | 519234 |
| Credential Number | PCY.0002129 |
| Credential Type | PHARMACY |
| Business Address |
3465 Berlin Tpke Newington CT 06111-5106 |
| Business Type | PARTNERSHIP |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-07-02 |
| Effective Date | 2019-09-01 |
| Expiration Date | 2020-08-31 |
| Refresh Date | 2019-08-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 519236 | PME.0007972 | NON LEGEND DRUG PERMIT | 2008-11-13 | 2008-11-13 - 2009-12-31 | INACTIVE |
| Street Address | 3465 BERLIN TPKE |
| City | NEWINGTON |
| State | CT |
| Zip Code | 06111-5106 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Charnelle Jamila Raphael | 3465 Berlin Tpke, Newington, CT 06111-5106 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Sams Club #6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Sam's Club 6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Non-alcoholic Beverage & Water Bottlers | 2020-07-01 ~ 2021-06-30 |
| Jeffrey T Depascale · Sam's Club | 3465 Berlin Tpke, Newington, CT 06111-5106 | Package Store Liquor | 2020-04-09 ~ 2021-04-08 |
| Sam's Club #6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Non Legend Drug Permit | 2020-01-01 ~ 2020-12-31 |
| Sam's Club Gas Station #6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Retail Gasoline Dealer | 2019-11-01 ~ 2020-10-31 |
| Karla Rodriquez | 3465 Berlin Tpke, Newington, CT 06111-5106 | Pharmacy Technician | 2015-07-24 ~ 2016-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stew Leonards | 3475 Berlin Tpke, Newington, CT 06111-5106 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Anastasios Gavrilis · Olympia Diner | 3413 Berlin Tpke, Newington, CT 06111-5106 | Restaurant Liquor | 2019-09-22 ~ 2021-01-21 |
| Stew Leonards' Newington | 3475 Berlin Tpke, Newington, CT 06111-5106 | Lottery Sales Agent | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anastasya Anisimova | 114 Fox Run Court, Newington, CT 06111 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Karen S Cleaveland | 52 Amidon Ave, Newington, CT 06111 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Leeann R Johnson | 17 Cinnamon Rd, Newington, CT 06111 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Isma Mian | 65 Cortland Way, Newington, CT 06111 | Physician/surgeon | ~ |
| Danielle Rocha | 1582 Willard Ave, Newington, CT 06111 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Munson's Chocolates | 3157 Berlin Tpke, Newington, CT 06111 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Shandea Edwards | 21 Hartford Ave #14, Newington, CT 06111 | Medication Administration Certification | ~ |
| Hengchao Xiong | 47 Adam Dr, Newington, CT 06111 | Nail Technician | ~ |
| Tuyen Le Phan | 71 Lantern Hill, Newington, CT 06111 | Nail Technician | ~ |
| Smita Parth Dave | 192 Brookside Rd, Newington, CT 06111 | Esthetician | ~ |
| Find all Licenses in zip 06111 | |||
| City | NEWINGTON |
| Zip Code | 06111 |
| License Type | PHARMACY |
| License Type + County | PHARMACY + NEWINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sam's Club 6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Non-alcoholic Beverage & Water Bottlers | 2020-07-01 ~ 2021-06-30 |
| Sam's Club #6636 · Wal-mart Stores Inc | 245 Wilbur Cross Hwy, Berlin, CT 06037 | Non Legend Drug Permit | 1997-01-01 ~ 1997-12-31 |
| Sam's Club #6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Non Legend Drug Permit | 2020-01-01 ~ 2020-12-31 |
| Sam's Club Gas Station #6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Retail Gasoline Dealer | 2019-11-01 ~ 2020-10-31 |
| Sam's Club Gas Station #6636 | 76 Rowley St, Newington, CT 06111-5529 | Operator of Weighing & Measuring Devices | 2019-08-01 ~ 2020-07-31 |
| Sams Club #6636 | 3465 Berlin Tpke, Newington, CT 06111-5106 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Waybrid T24 Pr 6636 | 856 Echo Lake Rd, Watertown, CT 06795 | Medical Marijuana Producer Brand Registration | 2019-04-24 ~ |
| Desert Rx Pharmacy | 73091 Country Club Dr Ste A4, Palm Desert, CA 92260-2338 | Nonresident Pharmacy | ~ |
| Diabetes Care Club LLC · Rx Care Club | 500 Eagles Landing Dr Ste B, Lakeland, FL 33810-2899 | Nonresident Pharmacy | 2013-09-01 ~ 2014-08-31 |
| Cvs Pharmacy · Cvs Pharmacy Central Pharmacy Services | 25 Blackstone Valley Pl, Lincoln, RI 02865-1184 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
Please comment or provide details below to improve the information on SAM'S CLUB PHARMACY #10-6636.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).