Healthcare Provider Details

I. General information

NPI: 1962336719
Provider Name (Legal Business Name): MICHELLE RASO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 HIGHLAND CORPORATE DR
CUMBERLAND RI
02864-8703
US

IV. Provider business mailing address

2100 HIGHLAND CORPORATE DR
CUMBERLAND RI
02864-8703
US

V. Phone/Fax

Practice location:
  • Phone: 866-908-2343
  • Fax:
Mailing address:
  • Phone: 866-908-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033.0135709
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH04267
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063695-01
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0009621
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS026847
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: