Provider Demographics
NPI:1912616871
Name:KHOURY, GABRIELLA (RPH)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLA
Middle Name:
Last Name:KHOURY
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 1:40 OLD LOUISQUISSET PIKE UNIT 802
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-8250
Mailing Address - Country:US
Mailing Address - Phone:401-654-0093
Mailing Address - Fax:
Practice Address - Street 1:595 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7226
Practice Address - Country:US
Practice Address - Phone:401-765-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH06381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist