Provider Demographics
NPI:1205424595
Name:BAPTISTA, TODD RANDALL (RPH)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:RANDALL
Last Name:BAPTISTA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 JASON DR
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-1110
Mailing Address - Country:US
Mailing Address - Phone:508-742-7441
Mailing Address - Fax:
Practice Address - Street 1:30 CENTRE OF NEW ENGLAND BLVD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6068
Practice Address - Country:US
Practice Address - Phone:508-742-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21074183500000X
RI04158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist