Provider Demographics
NPI:1376811257
Name:MENDEZ, ROXANNE PATRICIA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:PATRICIA
Last Name:MENDEZ
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 1:278 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-1811
Mailing Address - Country:US
Mailing Address - Phone:508-615-2353
Mailing Address - Fax:
Practice Address - Street 1:937 W BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-1139
Practice Address - Country:US
Practice Address - Phone:508-856-7901
Practice Address - Fax:508-856-7907
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist