Provider Demographics
NPI:1831191865
Name:SOJA, WALTER DANIEL (RPH)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:DANIEL
Last Name:SOJA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DIXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5902
Mailing Address - Country:US
Mailing Address - Phone:401-785-0048
Mailing Address - Fax:401-455-6300
Practice Address - Street 1:345 BLACKSTONE BLVD
Practice Address - Street 2:DEPT OF PHARMACY
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4800
Practice Address - Country:US
Practice Address - Phone:401-455-6316
Practice Address - Fax:401-445-6300
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH2138183500000X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric