Provider Demographics
NPI:1780289785
Name:ROCHEFORT, BALEY V (PHARMD)
Entity type:Individual
Prefix:
First Name:BALEY
Middle Name:V
Last Name:ROCHEFORT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 W VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-7936
Mailing Address - Country:US
Mailing Address - Phone:401-862-1332
Mailing Address - Fax:
Practice Address - Street 1:99 E MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-4983
Practice Address - Country:US
Practice Address - Phone:401-847-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH006023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist