Provider Demographics
NPI:1831802602
Name:FIGUEIREDO, JASON A (CPHT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:FIGUEIREDO
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EDENDALE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1637
Mailing Address - Country:US
Mailing Address - Phone:401-744-5605
Mailing Address - Fax:
Practice Address - Street 1:1054 CASS AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4935
Practice Address - Country:US
Practice Address - Phone:401-767-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPH202782183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
1520889OtherNABP
RIPH202782OtherSTATE LICENSE
30200434OtherCPHT