Provider Demographics
NPI:1063017077
Name:WOJCIECHOWSKI, RENEE THERESE (RPH)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:THERESE
Last Name:WOJCIECHOWSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3986 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-2550
Mailing Address - Country:US
Mailing Address - Phone:401-364-0900
Mailing Address - Fax:
Practice Address - Street 1:3986 OLD POST RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813-2550
Practice Address - Country:US
Practice Address - Phone:401-364-0900
Practice Address - Fax:401-364-2285
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist