Healthcare Provider Details

I. General information

NPI: 1649522343
Provider Name (Legal Business Name): LUCY MARIA DIMASE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUCIA MARIA DIMASE PHARMD

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST RI HOSPITAL -PHARMACY DEPARTMENT
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

45 BALSAM DRIVE
EAST GREENWICH RI
02818
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-8172
  • Fax:
Mailing address:
  • Phone: 401-886-9736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number3828
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number3828
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: