Provider Demographics
NPI:1841575289
Name:PATNEAUDE, SHARON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:PATNEAUDE
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 1:210 CRANE AVE S
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1203
Mailing Address - Country:US
Mailing Address - Phone:508-942-7336
Mailing Address - Fax:
Practice Address - Street 1:5 TREMONT ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3054
Practice Address - Country:US
Practice Address - Phone:508-824-5332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist