MEDICARE: JOY PRISCILLA ALONZO RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH04717	RI

General Provider Information

NPI Number	:	1194990788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY PRISCILLA ALONZO RPH

Provider Business Mailing Address
First Line	:	3 KERINS TER
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-4023
Country	:	US
Telephone Number	:	401-619-2733
Fax Number	:

Provider Business Practice Location Address
First Line	:	3034 E MAIN RD
Second Line	:
City	:	PORTSMOUTH
State	:	RI
Zip	:	02871-4205
Country	:	US
Telephone Number	:	401-683-1270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	04/24/2008

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