Healthcare Provider Details
I. General information
NPI: 1700277175
Provider Name (Legal Business Name): RAYMOND CHRISTOPHER DURIGAN III PHARMD,BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/06/2015
Last Update Date: 10/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
450 CLINTON ST THUNDERMIST HEALTH CENTER
WOONSOCKET RI
02895-3207
US
IV. Provider business mailing address
128 HOPE HILL TER
CRANSTON RI
02921-2729
US
V. Phone/Fax
- Phone: 401-767-4000
- Fax: 401-235-6893
- Phone: 401-225-4994
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | RP449025 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P2201X |
| Taxonomy | Ambulatory Care Pharmacist |
| License Number | RPH05636 |
| License Number State | RI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: