Provider Demographics
NPI:1710574694
Name:IVANOSKI, CHRISTOPHER ALAN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:IVANOSKI
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OLD CHIMNEY RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CVS DR
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-6146
Practice Address - Country:US
Practice Address - Phone:401-770-5606
Practice Address - Fax:401-216-3770
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05435183500000X
CTPCT.0013260183500000X
HIPH-3989183500000X
MAPHP232600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist