MEDICARE: ROBERT VINCELETTE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH20273	MA

General Provider Information

NPI Number	:	1194329383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT VINCELETTE RPH

Provider Business Mailing Address
First Line	:	25 FAUNCE CORNER RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-4202
Country	:	US
Telephone Number	:	508-999-7300
Fax Number	:	508-999-3137

Provider Business Practice Location Address
First Line	:	25 FAUNCE CORNER RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-4202
Country	:	US
Telephone Number	:	508-999-7300
Fax Number	:	508-999-3137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2020
Last Update Date	:	11/28/2020

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