Provider Demographics
NPI:1639463839
Name:ARCHETTO, DEBRA A
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:ARCHETTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 PUTNAM PIKE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-3008
Mailing Address - Country:US
Mailing Address - Phone:401-949-6212
Mailing Address - Fax:401-949-6217
Practice Address - Street 1:452 PUTNAM PIKE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-3008
Practice Address - Country:US
Practice Address - Phone:401-949-6212
Practice Address - Fax:401-949-6217
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI03968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist