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NPI 1164587580

OrganizationActive

Bonneville Rx LLC

NPI 1164587580 · Community/Retail Pharmacy · Danielson, CT

Provider details

NPI number: 1164587580
Entity type: Organization
Primary specialty: Community/Retail PharmacySuppliers
Authorized official: Ravinder Annamaneni, Member
License: PCY0000159 (CT)

Practice location

77 Westcott Rd

Danielson, CT 06239-2929

Phone: (860) 774-9362

Fax: (860) 779-2647

More CT providers

Mailing address

77 Westcott Rd

Danielson, CT 06239-2929

Registry dates

Enumerated: 2006-12-26
Last updated: 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.

Bonneville Rx LLC — NPI 1164587580, Danielson, CT | NPI Central