Healthcare Provider Details

I. General information

NPI: 1487291563
Provider Name (Legal Business Name): ANGELA M RUGGIERO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2019
Last Update Date: 12/07/2019
Certification Date: 12/07/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PAGE ST
NEW BEDFORD MA
02740-3464
US

IV. Provider business mailing address

152 FEDERAL FURNACE RD
PLYMOUTH MA
02360-4762
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-5450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR69127
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH238748
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: