Provider Demographics
NPI:1346786977
Name:PRESCRIPTION PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:PRESCRIPTION PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN HCARGE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:401-228-3047
Mailing Address - Street 1:1210 PONTIAC AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-4490
Mailing Address - Country:US
Mailing Address - Phone:401-467-2223
Mailing Address - Fax:401-781-4570
Practice Address - Street 1:285 GOVERNOR ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3237
Practice Address - Country:US
Practice Address - Phone:401-228-3388
Practice Address - Fax:855-439-4579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WD0400X, 333600000X
RIPHA006153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167281OtherPK