Provider Demographics
NPI:1720637226
Name:MCQUADE'S JAMESTOWN PHARMACY, LLC
Entity Type:Organization
Organization Name:MCQUADE'S JAMESTOWN PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUADE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:401-596-2054
Mailing Address - Street 1:6 CLARKE ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02835
Mailing Address - Country:US
Mailing Address - Phone:401-596-2054
Mailing Address - Fax:
Practice Address - Street 1:6 CLARKE ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02835
Practice Address - Country:US
Practice Address - Phone:401-596-2054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy