Provider Demographics
NPI:1912398389
Name:GELINAS, RITA MARIE
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:MARIE
Last Name:GELINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 REGENCY DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-2053
Mailing Address - Country:US
Mailing Address - Phone:508-361-6427
Mailing Address - Fax:
Practice Address - Street 1:39 REGENCY DR
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-2053
Practice Address - Country:US
Practice Address - Phone:508-361-6427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPT2601183700000X
MA380100106110180183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician