Provider Demographics
NPI:1336840867
Name:AINLEY, MEAV TAN (RPH)
Entity Type:Individual
Prefix:
First Name:MEAV
Middle Name:TAN
Last Name:AINLEY
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 1:245 CHAPMAN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4539
Mailing Address - Country:US
Mailing Address - Phone:401-606-6320
Mailing Address - Fax:
Practice Address - Street 1:245 CHAPMAN ST STE 300
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4539
Practice Address - Country:US
Practice Address - Phone:401-606-6320
Practice Address - Fax:401-444-4445
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH39201835P0018X, 1835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist