=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336989144
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STARMONIQUE BARROWS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2024
-----------------------------------------------------
Last Update Date | 05/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 397 LINCOLN RD
-----------------------------------------------------
City | WALPOLE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02081-1218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-668-7703
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1306 VILLAGE RD E
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02062-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-447-9797
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183700000X
-----------------------------------------------------
Taxonomy Name | Pharmacy Technician
-----------------------------------------------------
License Number | PT26087
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------