Healthcare Provider Details

I. General information

NPI: 1932182490
Provider Name (Legal Business Name): DAVID PATRICK WHALLEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 BROADWAY
NEWPORT RI
02840-2613
US

IV. Provider business mailing address

289 BROADWAY
NEWPORT RI
02840-2613
US

V. Phone/Fax

Practice location:
  • Phone: 401-847-6762
  • Fax: 401-846-4433
Mailing address:
  • Phone: 401-847-6762
  • Fax: 401-846-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2424
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: