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General NPI Number Information
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NPI Number | 1700871332
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Entity Type | Individual
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Provider Name | KERRI L DEPROFIO RPH
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Gender | Female
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 228 BILLERICA RD PHARMACY DEPARTMENT
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City | CHELMSFORD
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State | MA
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Zip | 01824-3604
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Country | US
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Telephone | 978-250-6162
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Fax | 978-250-6229
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Provider Business Mailing Address
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Address Line | 6 PRIMROSE RD
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City | BILLERICA
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State | MA
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Zip | 01821-3026
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Country | US
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Telephone | 978-670-8949
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Fax | 978-250-6229
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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 | 24177
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License Number State | MA
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