Provider Demographics
NPI:1700163763
Name:RANUCCI, STACEY JEAN (RPH)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:JEAN
Last Name:RANUCCI
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 1:268 SLEEPY HOLLOW FARM RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0408
Mailing Address - Country:US
Mailing Address - Phone:401-398-7722
Mailing Address - Fax:401-398-7722
Practice Address - Street 1:268 SLEEPY HOLLOW FARM RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0408
Practice Address - Country:US
Practice Address - Phone:401-398-7722
Practice Address - Fax:401-398-7722
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI4033183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist