Provider Demographics
NPI:1679864367
Name:ALMEIDA, JACQUELYN A (RPH)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:A
Last Name:ALMEIDA
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 1:85 HUTTLESTON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-3156
Mailing Address - Country:US
Mailing Address - Phone:508-999-2920
Mailing Address - Fax:508-997-2633
Practice Address - Street 1:85 HUTTLESTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-3156
Practice Address - Country:US
Practice Address - Phone:508-999-2920
Practice Address - Fax:508-997-2633
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist