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General NPI Number Information
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NPI Number | 1699271403
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Entity Type | Organization
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Legal Business Name | RHODE ISLAND VETERANS HOME
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 04/02/2018
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Provider Practice Location Address
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Address Line | 480 METACOM AVE
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City | BRISTOL
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State | RI
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Zip | 02809-5119
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Country | US
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Telephone | 401-253-8000
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Fax | 401-396-8125
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Provider Business Mailing Address
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Address Line | 480 METACOM AVE
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City | BRISTOL
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State | RI
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Zip | 02809-5119
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Country | US
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Telephone | 401-253-8000
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Fax | 401-396-8125
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY SERVICES
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Name | NIGEL MUSGRAVE
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Credential |
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Telephone | 401-253-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHB00029
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License Number State | RI
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