Provider Demographics
NPI:1043927072
Name:DUPREY, MICHAEL D JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:DUPREY
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CATALPA WAY
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-6468
Mailing Address - Country:US
Mailing Address - Phone:860-302-8703
Mailing Address - Fax:
Practice Address - Street 1:117 CHAPMAN ST STE 200
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-5400
Practice Address - Country:US
Practice Address - Phone:401-606-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist