Healthcare Provider Details

I. General information

NPI: 1871887208
Provider Name (Legal Business Name): LISA REILLY PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CVS DR
WOONSOCKET RI
02895-6195
US

IV. Provider business mailing address

1 CVS DR
WOONSOCKET RI
02895-6195
US

V. Phone/Fax

Practice location:
  • Phone: 774-265-0061
  • Fax:
Mailing address:
  • Phone: 774-265-0061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH232554
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: