Healthcare Provider Details

I. General information

NPI: 1013018613
Provider Name (Legal Business Name): MCQUADES MARKET PLACE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MAIN ST
WESTERLY RI
02891-2114
US

IV. Provider business mailing address

106 MAIN ST
WESTERLY RI
02891-2114
US

V. Phone/Fax

Practice location:
  • Phone: 401-596-0277
  • Fax: 401-596-5461
Mailing address:
  • Phone: 401-596-0277
  • Fax: 401-596-5461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHA00021
License Number StateRI

VIII. Authorized Official

Name: COURTNEY N MCQUADE
Title or Position: OWNER/RPH
Credential:
Phone: 401-596-8843