Provider Demographics
NPI:1043935794
Name:DEMELLO, ROSARY MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSARY
Middle Name:MARIE
Last Name:DEMELLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PERRY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-1419
Mailing Address - Country:US
Mailing Address - Phone:508-525-0835
Mailing Address - Fax:
Practice Address - Street 1:2100 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-6310
Practice Address - Country:US
Practice Address - Phone:508-995-2653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH22423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist