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General NPI Number Information
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NPI Number | 1467072199
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Entity Type | Individual
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Provider Name | DAVID JUSTIN GIFFIN CPHT
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Gender | Male
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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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 | 401-770-3209
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Fax |
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Provider Business Mailing Address
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Address Line | 2 REGENCY PLZ APT 808
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City | PROVIDENCE
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State | RI
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Zip | 02903-3150
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Country | US
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Telephone | 814-954-2634
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | T10696
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License Number State | MD
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