Provider Demographics
NPI:1851690093
Name:TAXTER, DARICE MICHELE (RPH)
Entity Type:Individual
Prefix:
First Name:DARICE
Middle Name:MICHELE
Last Name:TAXTER
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 1:10 PLEASANT STREET
Mailing Address - Street 2:BIG Y PHARMACY #37
Mailing Address - City:LEE
Mailing Address - State:MA
Mailing Address - Zip Code:01238
Mailing Address - Country:US
Mailing Address - Phone:413-243-1007
Mailing Address - Fax:
Practice Address - Street 1:10 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238
Practice Address - Country:US
Practice Address - Phone:413-243-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-26
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24328183500000X
FLPS34681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist