Provider Demographics
NPI:1083999593
Name:CHIN, MICHAEL Y (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:Y
Last Name:CHIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 POST RD
Mailing Address - Street 2:WALGREENS
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7132
Mailing Address - Country:US
Mailing Address - Phone:401-737-1952
Mailing Address - Fax:401-737-6468
Practice Address - Street 1:3336 POST RD
Practice Address - Street 2:WALGREENS
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7132
Practice Address - Country:US
Practice Address - Phone:401-737-1952
Practice Address - Fax:401-737-6468
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH03652183500000X
MAPH22074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist