BLACK ROCK PHARMACY LLC (NPI# 1295209773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295209773 |
| Entity Type | Organization |
| Organization Name | BLACK ROCK PHARMACY LLC |
| Practice Address |
1838 Black Rock Tpke Fairfield CT 06825-3500 |
| Practice Telephone | 9175321285 |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2019-01-17 |
| Authorized Official Name | KENNETH H LEE (OWNER) |
| Authorized Official Telephone | 9175321285 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | PHARMACY LICENSE | 2386 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | BLACK ROCK PHARMACY LLC | 1838 Black Rock Turnpike, Fairfield, CT 06825 |
| Street Address |
1838 BLACK ROCK TPKE |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06825-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376535 | Andrew Kalach | Physical Therapist | 2373 Black Rock Turnpike, Fairfield, CT 06825 | 2020-08-13 |
| 1346871423 | Clarivision-advanced Eye Care | Optometrist | 40 Black Rock Turnpike, Fairfield, CT 06825 | 2020-01-28 |
| 1730720145 | L Burke LLC | Marriage & Family Therapist | 2501 Old Post Rd, 2nd Floor, Fairfield, CT 06825 | 2019-10-07 |
| 1760045066 | Stephen Miguel Pou | Dentist | 2150 Black Rock Tpke Ste 201, Fairfield, CT 06825 | 2019-04-22 |
| 1548716111 | Connecticut Orthopaedic Specialists, PC | Specialist | 425 Boston Post Road, Fairfield, CT 06825 | 2016-09-01 |
| 1497131239 | Alice Z Kelly | Social Worker | 113 Sky Top Drive, Fairfield, CT 06825 | 2015-08-04 |
| 1902218647 | John Feiler | Occupational Therapist | 175 Jefferson St., Fairfield, CT 06825 | 2014-05-29 |
| 1710242870 | Bridge Partnership, LLC | Community/Behavioral Health | 2505 Black Rock Turnpike, 2nd Floor, Fairfield, CT 06825 | 2012-07-05 |
| 1154614543 | Center for The Healing Arts, PC | Internal Medicine | 501 Kings Highway East, Suite 108, C/o Whole Body Medicine, Fairfield, CT 06825 | 2011-05-18 |
| 1538468012 | Barbara Cohen | Occupational Therapist | 175 Jefferson Street, Fairfield, CT 06825 | 2011-03-23 |
| Find all providers in zip 06825 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215084561 | Payless Drugs, Inc. | Pharmacy | 4901 Gary Ave, Fairfield, AL 35064-1348 | 2007-01-05 |
| 1295830040 | Connecticut Cvs Pharmacy LLC | Pharmacy | 1968 Black Rock Tpke, Fairway Plaza, Fairfield, CT 06825-3543 | 2006-09-14 |
| 1255434957 | Ohio Cvs Stores LLC | Pharmacy | 590 Nilles Rd, Fairfield, OH 45014-2606 | 2006-09-07 |
| 1033229794 | Raleys | Pharmacy | 3001 Travis Blvd., Fairfield, CA 94534-3442 | 2006-08-30 |
| 1184636359 | Coram Alternate Site Services, Inc. | Pharmacy | 4305 Mulhauser Rd, Suite 1, Fairfield, OH 45014-2263 | 2006-08-13 |
| 1639191232 | Garfield Beach Cvs LLC | Pharmacy | 2059 Cadenasso Dr, Fairfield, CA 94533-6806 | 2006-07-24 |
| 1235172024 | Longs Drug Stores California LLC | Pharmacy | 300 Travis Blvd, Fairfield, CA 94533-3804 | 2006-06-13 |
| 1154941870 | Summit Pharmacy of Iowa, Inc | Pharmacy | 300 W Burlington Ave, Fairfield, IA 52556-3241 | 2020-04-22 |
| 1720617509 | Melissa Adrian | Pharmacy | 1300 W Burlington Ave, Fairfield, IA 52556-2766 | 2020-04-03 |
| 1457995516 | Family Health Services Corporation | Pharmacy | 401 W Camas Ave, Fairfield, ID 83327 | 2019-11-01 |
| Find all providers in FAIRFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.