Provider Demographics
NPI:1235733288
Name:PERICH, MORGAN KIRSTEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:KIRSTEN
Last Name:PERICH
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 1:91 MAIN ST UNIT 333B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-4433
Mailing Address - Country:US
Mailing Address - Phone:973-670-1740
Mailing Address - Fax:
Practice Address - Street 1:198 BUTTONWOODS AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7541
Practice Address - Country:US
Practice Address - Phone:401-739-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH06151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist