=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255495974
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RITA ELIAS AOUN RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 942 HYDE PARK AVE # A
-----------------------------------------------------
City | HYDE PARK
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02136-3269
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-361-0489
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30 CHASE DR
-----------------------------------------------------
City | SHARON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02067-2931
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-784-7774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 24313
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------