Provider Demographics
NPI:1114249992
Name:STLAURENT, RENE E (RPH, CCN)
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:E
Last Name:STLAURENT
Suffix:
Gender:M
Credentials:RPH, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 AQUIDNECK AVE
Mailing Address - Street 2:AQUIDNECK NUTRIENTS & WELLNESS CENTER
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842
Mailing Address - Country:US
Mailing Address - Phone:401-324-6167
Mailing Address - Fax:401-324-6168
Practice Address - Street 1:770 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842
Practice Address - Country:US
Practice Address - Phone:401-324-6167
Practice Address - Fax:401-324-6168
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist