Provider Demographics
NPI:1851996771
Name:POUDRIER, VALERIE A (RPH)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:POUDRIER
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 1:14 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-6020
Mailing Address - Country:US
Mailing Address - Phone:774-535-3139
Mailing Address - Fax:
Practice Address - Street 1:400 PARK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1025
Practice Address - Country:US
Practice Address - Phone:508-792-3866
Practice Address - Fax:508-797-0713
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist