Provider Demographics
NPI:1821112319
Name:SHARPE, BETHANY LEIGH (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LEIGH
Last Name:SHARPE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 VILLAGE GRN S APT A
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-4024
Mailing Address - Country:US
Mailing Address - Phone:401-270-7316
Mailing Address - Fax:
Practice Address - Street 1:1086 WILLETT AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2042
Practice Address - Country:US
Practice Address - Phone:401-433-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist