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General NPI Number Information
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NPI Number | 1043935794
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Entity Type | Individual
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Provider Name | ROSARY MARIE DEMELLO PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 2100 ACUSHNET AVE
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City | NEW BEDFORD
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State | MA
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Zip | 02745-6310
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Country | US
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Telephone | 508-995-2653
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Fax |
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Provider Business Mailing Address
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Address Line | 11 PERRY AVE
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City | EAST WAREHAM
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State | MA
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Zip | 02538-1419
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Country | US
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Telephone | 508-525-0835
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH22423
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License Number State | MA
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