Provider Demographics
NPI:1912273194
Name:LARIVIERE, KHRISTINE S (RPH)
Entity Type:Individual
Prefix:
First Name:KHRISTINE
Middle Name:S
Last Name:LARIVIERE
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 1:58 TUM A LUM CIR
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-3156
Mailing Address - Country:US
Mailing Address - Phone:860-460-6743
Mailing Address - Fax:
Practice Address - Street 1:67 SANDY DESERT RD
Practice Address - Street 2:
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-1111
Practice Address - Country:US
Practice Address - Phone:855-664-4679
Practice Address - Fax:860-862-9099
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3455183500000X
KY18362183500000X
AL18120183500000X
MAPH232932183500000X
AZS021075183500000X
RIRPH04838183500000X
VA202212884183500000X
TX59689183500000X
TN37926183500000X
ORRPH-0014832183500000X
LAPST.021988183500000X
OK16737183500000X
MDMD23345183500000X
CTPCT.0011317183500000X
MST-13794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist