Healthcare Provider Details

I. General information

NPI: 1720721970
Provider Name (Legal Business Name): VACCINE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 04/15/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ITITCHING POST ROAD
WALPOLE MA
08081
US

IV. Provider business mailing address

3595 POST RD APT 1105
WARWICK RI
02886-7000
US

V. Phone/Fax

Practice location:
  • Phone: 401-585-3226
  • Fax:
Mailing address:
  • Phone: 401-585-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS MARIAH PELKEY
Title or Position: CEO
Credential: LPN
Phone: 401-585-3226