MEDICARE: MRS. JESSICA L ESPOSITO 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	RPH04325	RI

General Provider Information

NPI Number	:	1659661197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA L ESPOSITO RPH

Provider Business Mailing Address
First Line	:	1200 N MAIN ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-1820
Country	:	US
Telephone Number	:	401-272-3048
Fax Number	:	401-621-1888

Provider Business Practice Location Address
First Line	:	1200 N MAIN ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-1820
Country	:	US
Telephone Number	:	401-272-3048
Fax Number	:	401-621-1888

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

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	04/18/2011

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