Provider Demographics
NPI:1710267919
Name:SPINELLA, RAYMOND ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:ANTHONY
Last Name:SPINELLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MINERAL SPRING AVE
Mailing Address - Street 2:(RITE AID PHARMACY)
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-726-0547
Mailing Address - Fax:401-726-8573
Practice Address - Street 1:150 MINERAL SPRING AVE
Practice Address - Street 2:(RITE AID PHARMACY)
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:401-726-0547
Practice Address - Fax:401-726-8573
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist