=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447320056
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASCO HEALTHCARE OF NEW ENGLAND LIMITED PARTNERSHIP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2006
-----------------------------------------------------
Last Update Date | 06/30/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30 CENTRE OF NEW ENGLAND BLVD
-----------------------------------------------------
City | COVENTRY
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02816-6068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-823-8575
-----------------------------------------------------
Fax | 401-823-4161
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 CVS DR BOX 1075
-----------------------------------------------------
City | WOONSOCKET
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02895-6146
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR DIRECTOR, PAYER RELATIONS
-----------------------------------------------------
Name | SUSAN COLBERT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 401-770-2751
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------