OrganizationActive
Bonneville Rx LLC
NPI 1164587580 · Community/Retail Pharmacy · Danielson, CT
Bonneville Rx LLC is a Community/Retail Pharmacy organization in Danielson, CT (NPI 1164587580).
Provider details
- NPI number
- 1164587580
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Ravinder Annamaneni, Member(860) 774-9362
- License
- PCY0000159 (CT)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
77 Westcott Rd
Danielson, CT 06239-2929
Phone: (860) 774-9362
Fax: (860) 779-2647
Street-level locationGet directions
Mailing address
77 Westcott Rd
Danielson, CT 06239-2929
Other names (DBA / former)
- Doing business as
- Bonneville Pharmacy
Registry dates
- Enumerated
- 2006-12-26
- Last updated
- 2013-09-09
Frequently asked questions
- What is Bonneville Rx LLC's NPI number?
- Bonneville Rx LLC's National Provider Identifier (NPI) is 1164587580, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bonneville Rx LLC?
- Bonneville Rx LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Bonneville Rx LLC located?
- Bonneville Rx LLC's practice location on file with NPPES is 77 Westcott Rd, Danielson, CT 06239-2929.
- What is Bonneville Rx LLC's phone number?
- The practice phone number listed in the NPPES registry for Bonneville Rx LLC is (860) 774-9362.
- Who is the authorized official for Bonneville Rx LLC?
- The authorized official listed on Bonneville Rx LLC's NPPES record is Ravinder Annamaneni, Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bonneville Rx LLC's NPI active?
- Yes — Bonneville Rx LLC's NPI (1164587580) is active in the NPPES registry as of the last update on 2013-09-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.