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General NPI Number Information
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NPI Number | 1962091355
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Entity Type | Individual
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Provider Name | PATRICIA MARIE MATHEWS PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 01/11/2021
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 681 RESERVOIR AVE
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City | CRANSTON
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State | RI
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Zip | 02910-3220
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Country | US
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Telephone | 401-943-7186
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Fax |
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Provider Business Mailing Address
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Address Line | 100 ELENA ST APT 221
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City | CRANSTON
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State | RI
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Zip | 02920-4382
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Country | US
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Telephone | 906-201-0233
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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 | 5351010276
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License Number State | MI
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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 | RPH06473
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License Number State | RI
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