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General NPI Number Information
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NPI Number | 1730775867
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Entity Type | Individual
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Provider Name | ADAM RUCANDO
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Gender | Male
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Dates
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Enumeration Date | 12/13/2020
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Last Update Date | 12/13/2020
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Provider Practice Location Address
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Address Line | 1360 W MAIN RD
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City | MIDDLETOWN
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State | RI
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Zip | 02842-6301
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Country | US
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Telephone | 401-849-9640
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Fax | 401-849-0848
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Provider Business Mailing Address
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Address Line | 77 BASIN ST
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City | PORTSMOUTH
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State | RI
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Zip | 02871-2801
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Country | US
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Telephone | 401-450-2972
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03742
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License Number State | RI
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