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Lattana Tina Kettavong, PHARMD

NPI 1245998996ActiveIndividual· Pharmacist· Clinton, CT

Pharmacist (PHARMD) in Clinton, Connecticut, licensed in CT, with an NPI issued in November 2021. Part D covered 76 prescriptions written in 2024, 0% of them generic.

Overview

NPI1245998996
StatusActive
Entity typeIndividual
CredentialPHARMD
Sole proprietorNo
NPI issuedNov 30, 2021
Last updated in NPPESNov 30, 2021
Certified by providerNov 30, 2021

Specialties and licenses

TaxonomyCodeLicenseState
Pharmacist Primary183500000XPCT.0015656CT

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Part D prescriptions in 2024

Prescriptions (claims)76 · 76 30-day fills
Patients64
Total drug cost$11,961
Generic share0% of claims

Medicare sources and data years

Other pharmacists in Clinton

All 15 pharmacists in Clinton · All pharmacists in Connecticut