Provider Demographics
NPI:1598368219
Name:GAUL, KEVIN EDWARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:EDWARD
Last Name:GAUL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BROAD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CENTRAL FALLS
Mailing Address - State:RI
Mailing Address - Zip Code:02863-1507
Mailing Address - Country:US
Mailing Address - Phone:401-288-0035
Mailing Address - Fax:401-369-9534
Practice Address - Street 1:1000 BROAD ST STE 102
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-1507
Practice Address - Country:US
Practice Address - Phone:401-288-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist