Healthcare Provider Details

I. General information

NPI: 1548392921
Provider Name (Legal Business Name): LISA MARZILLI RPH, PHARMD, CDOE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 BALD HILL RD BROOKS PHARMACY
WARWICK RI
02886-0744
US

IV. Provider business mailing address

PO BOX 7228
WARWICK RI
02887-7228
US

V. Phone/Fax

Practice location:
  • Phone: 401-480-2193
  • Fax:
Mailing address:
  • Phone: 401-480-2193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number3340
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number3340
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: