Provider Demographics
NPI:1497358923
Name:PEARSON, EMILY ROSE (RPH)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ROSE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ADMIRAL ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2416
Mailing Address - Country:US
Mailing Address - Phone:401-351-5030
Mailing Address - Fax:401-331-4960
Practice Address - Street 1:400 ADMIRAL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-2416
Practice Address - Country:US
Practice Address - Phone:401-351-5030
Practice Address - Fax:401-331-4960
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist