Provider Demographics
NPI:1023997798
Name:CONNECTRX LATHAM, LLC
Entity type:Organization
Organization Name:CONNECTRX LATHAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PHARMACY SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOTALING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-653-9574
Mailing Address - Street 1:6 WELLNESS WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2142
Mailing Address - Country:US
Mailing Address - Phone:518-313-1016
Mailing Address - Fax:518-313-0790
Practice Address - Street 1:6 WELLNESS WAY STE 104
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2142
Practice Address - Country:US
Practice Address - Phone:518-313-1016
Practice Address - Fax:518-313-0790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy