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General NPI Number Information
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NPI Number | 1144336801
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Entity Type | Individual
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Provider Name | STACY INMAN PHARMD, CDE
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 CVS DR
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City | WOONSOCKET
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State | RI
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Zip | 02895-6146
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Country | US
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Telephone | 401-770-3764
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Fax | 401-652-1889
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Provider Business Mailing Address
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Address Line | 771 BROADWAY
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City | FALL RIVER
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State | MA
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Zip | 02724-2700
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Country | US
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Telephone |
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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 | 4084
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License Number State | RI
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