Healthcare Provider Details

I. General information

NPI: 1346786977
Provider Name (Legal Business Name): PRESCRIPTION PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 GOVERNOR ST LOWR LEVEL
PROVIDENCE RI
02906-3237
US

IV. Provider business mailing address

1210 PONTIAC AVE 3RD FLOOR
CRANSTON RI
02920-4490
US

V. Phone/Fax

Practice location:
  • Phone: 401-228-3388
  • Fax: 855-439-4579
Mailing address:
  • Phone: 401-467-2223
  • Fax: 401-781-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHA00615
License Number StateRI

VIII. Authorized Official

Name: CHRISTINE DYER
Title or Position: PHARMACIST IN HCARGE
Credential: RPH
Phone: 401-228-3047