Provider Demographics
NPI:1558111922
Name:ROCHA, AMANDA ROSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ROSE
Last Name:ROCHA
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 1:2 HEDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-4314
Mailing Address - Country:US
Mailing Address - Phone:401-714-2909
Mailing Address - Fax:
Practice Address - Street 1:1195 OAKLAWN AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-2620
Practice Address - Country:US
Practice Address - Phone:401-463-1971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH0660361835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist