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General NPI Number Information
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NPI Number | 1013018613
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Entity Type | Organization
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Legal Business Name | MCQUADES MARKET PLACE PHARMACY INC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 106 MAIN ST
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City | WESTERLY
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State | RI
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Zip | 02891-2114
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Country | US
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Telephone | 401-596-0277
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Fax | 401-596-5461
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Provider Business Mailing Address
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Address Line | 106 MAIN ST
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City | WESTERLY
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State | RI
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Zip | 02891-2114
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Country | US
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Telephone | 401-596-0277
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Fax | 401-596-5461
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL MCQUADE
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Credential |
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Telephone | 401-596-0277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHA00021
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License Number State | RI
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