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General NPI Number Information
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NPI Number | 1558639732
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Entity Type | Individual
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Provider Name | HEATHER MAE GRANT PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 43 ORCHARD AVE
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City | WAKEFIELD
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State | RI
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Zip | 02879-3518
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Country | US
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Telephone | 401-932-4414
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Fax | 401-539-2048
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Provider Business Mailing Address
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Address Line | 43 ORCHARD AVE
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City | WAKEFIELD
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State | RI
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Zip | 02879-3518
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Country | US
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Telephone | 401-932-4414
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Fax | 401-539-2048
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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 | RPH04885
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03172400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH233346
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License Number State | MA
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