{"npi":"1174807002","type":"NPI-2","status":"active","name":{"display":"Procare Ltc Pharmacy Of Connecticut LLC","other":[],"organization_name":"PROCARE LTC PHARMACY OF CONNECTICUT LLC","authorised_official":"Bincy Varghese"},"specialty":{"primary_taxonomy":"3336L0003X","primary_taxonomy_description":"Long Term Care Pharmacy","slug":"long-term-care-pharmacy","schema_org_specialty":null,"all":[{"code":"3336L0003X","description":"Long Term Care Pharmacy","primary":false,"state":"RI","license":"PHN11041"},{"code":"333600000X","description":"Pharmacy","primary":false,"state":"NY","license":"031744"},{"code":"3336L0003X","description":"Long Term Care Pharmacy","primary":true,"state":"CT","license":"PCY0002214"}]},"addresses":[{"purpose":"LOCATION","street_1":"1492 HIGHLAND AVE STE 1C","city":"CHESHIRE","state":"CT","postal_code":"064101287","country_code":"US","phone":"2034399099","fax":"6319633990"},{"purpose":"MAILING","street_1":"1 OLYMPIC PL STE 600","city":"TOWSON","state":"MD","postal_code":"212044110","country_code":"US","phone":"8777410367"}],"license":{"state":"CT","number":"PCY0002214"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"02869827","state":"CT","issuer":null},{"type_code":"01","label":"Other","value":"2132865","state":null,"issuer":"PK"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20140124000454","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"CT","pac_id":"3577791300"},{"enrlmt_id":"O20210324003038","type_code":"12-73","type_desc":"PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)","state":"CT","pac_id":"3577791300"}]},"enumeration_date":"2011-10-11","last_updated":"2024-06-07","_meta":{"source":"NPPES","snapshot_date":"2024-06-07","doc_url":"https://findmynpi.com/api"}}