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General NPI Number Information
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NPI Number | 1619217502
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Entity Type | Organization
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Legal Business Name | MEDICATION MANAGEMENT LLC
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 600 PUTNAM PIKE SUITE 7
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City | GREENVILLE
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State | RI
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Zip | 02828-1486
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Country | US
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Telephone | 401-949-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 71 SEAVIEW AVE
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City | CRANSTON
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State | RI
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Zip | 02905-3615
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Country | US
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Telephone | 508-369-9888
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER/OWNER
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Name | LAURIE ANN WILSON
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Credential | N.P.
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Telephone | 508-369-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | NPP37242
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | RN40329
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License Number State | RI
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