Provider Demographics
NPI:1649608696
Name:PRESCRIPTION COMPOUNDING SPECIALISTS OF RI, INC.
Entity type:Organization
Organization Name:PRESCRIPTION COMPOUNDING SPECIALISTS OF RI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:ARVANITES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:401-429-0330
Mailing Address - Street 1:1145 RESERVOIR AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6055
Mailing Address - Country:US
Mailing Address - Phone:401-429-0330
Mailing Address - Fax:401-429-0333
Practice Address - Street 1:1145 RESERVOIR AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6055
Practice Address - Country:US
Practice Address - Phone:401-429-0330
Practice Address - Fax:401-429-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPHA005533336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy