Provider Demographics
NPI:1871197780
Name:CARELINK COLLABORATIVE PHARMACY LLC
Entity Type:Organization
Organization Name:CARELINK COLLABORATIVE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOUKIDES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:401-722-7600
Mailing Address - Street 1:400 MASSASOIT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-2012
Mailing Address - Country:US
Mailing Address - Phone:401-735-3131
Mailing Address - Fax:401-735-3133
Practice Address - Street 1:400 MASSASOIT AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2012
Practice Address - Country:US
Practice Address - Phone:401-735-3131
Practice Address - Fax:401-735-3133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy