MEDICARE: LISA B. SZUMITA PHARM.D., CDE

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	3715	RI
2	183500000X	Pharmacist	22416	MA

General Provider Information

NPI Number	:	1508895731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA B. SZUMITA PHARM.D., CDE

Provider Business Mailing Address
First Line	:	68 EVERETT DR
Second Line	:
City	:	RAYNHAM
State	:	MA
Zip	:	02767-1156
Country	:	US
Telephone Number	:	508-828-9739
Fax Number	:

Provider Business Practice Location Address
First Line	:	148 W RIVER ST
Second Line	:	SUITE 2A
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-2615
Country	:	US
Telephone Number	:	401-770-4846
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/08/2007

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