Healthcare Provider Details

I. General information

NPI: 1821112319
Provider Name (Legal Business Name): BETHANY LEIGH SHARPE PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 WILLETT AVE
RIVERSIDE RI
02915-2042
US

IV. Provider business mailing address

1935 VILLAGE GRN S APT A
RIVERSIDE RI
02915-4024
US

V. Phone/Fax

Practice location:
  • Phone: 401-433-5710
  • Fax:
Mailing address:
  • Phone: 401-270-7316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH04486
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: