Provider Demographics
NPI:1851709836
Name:ROSS, MICHELLE A (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:ROSS
Suffix:
Gender:F
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 1:123 NASHUA RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3453
Mailing Address - Country:US
Mailing Address - Phone:603-437-8100
Mailing Address - Fax:
Practice Address - Street 1:123 NASHUA RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3453
Practice Address - Country:US
Practice Address - Phone:603-437-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3969OtherRPH LICENSE