Provider Demographics
NPI:1689994816
Name:LARCH, HEATHER A (RPH)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:LARCH
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 1:90 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0111
Mailing Address - Country:US
Mailing Address - Phone:401-821-1263
Mailing Address - Fax:401-821-2841
Practice Address - Street 1:90 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0111
Practice Address - Country:US
Practice Address - Phone:401-821-1263
Practice Address - Fax:401-821-2841
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI4082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist