MEDICARE: BRIAN CARDARELLI

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	RPH03997	RI

General Provider Information

NPI Number	:	1821371469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CARDARELLI

Provider Business Mailing Address
First Line	:	1 COWESETT AVE
Second Line	:
City	:	WEST WARWICK
State	:	RI
Zip	:	02893-3207
Country	:	US
Telephone Number	:	401-826-0879
Fax Number	:	401-826-2628

Provider Business Practice Location Address
First Line	:	1 COWESETT AVE
Second Line	:
City	:	WEST WARWICK
State	:	RI
Zip	:	02893-3207
Country	:	US
Telephone Number	:	401-826-0879
Fax Number	:	401-826-2628

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

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	09/20/2011

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Directions to “ BRIAN CARDARELLI ” Practice Location

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