Provider Demographics
NPI:1841584703
Name:SALOIS, ROBERTA A (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:A
Last Name:SALOIS
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 1:2800 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-4244
Mailing Address - Country:US
Mailing Address - Phone:401-732-8599
Mailing Address - Fax:
Practice Address - Street 1:250 ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4053
Practice Address - Country:US
Practice Address - Phone:401-944-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist