Provider Demographics
NPI:1922691203
Name:JOSEPH, JEANNINE LOUISE (RPH)
Entity Type:Individual
Prefix:
First Name:JEANNINE
Middle Name:LOUISE
Last Name:JOSEPH
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 1:84 LONG HWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE COMPTON
Mailing Address - State:RI
Mailing Address - Zip Code:02837-1809
Mailing Address - Country:US
Mailing Address - Phone:617-548-3104
Mailing Address - Fax:
Practice Address - Street 1:333 MARIANO BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-2349
Practice Address - Country:US
Practice Address - Phone:508-675-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist