Provider Demographics
NPI:1609041896
Name:MEDEIROS, HELEN D (RPH)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:D
Last Name:MEDEIROS
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 1:170 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2462
Mailing Address - Country:US
Mailing Address - Phone:401-596-2734
Mailing Address - Fax:401-596-8521
Practice Address - Street 1:170 GRANITE ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2462
Practice Address - Country:US
Practice Address - Phone:401-596-2734
Practice Address - Fax:401-596-8521
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist