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Organization
GREEN LINE APOTHECARY LLC
Active
Organization
GREEN LINE APOTHECARY LLC
Active
Other names
Green Line Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA PROCACCIANTI PHARMD (OWNER, PIC, AO)
(401) 360-3200
Entity
Organization
Contact information
Practice address
245 MAIN ST, WAKEFIELD, RI 02879-3527
(401) 360-3300
(401) 783-0045
Mailing address
245 MAIN ST, WAKEFIELD, RI 02879-3527
(401) 360-3200
(401) 783-0045
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHA00608
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2156025
PK
—
Enumeration date
12/11/2015
Last updated
09/10/2021
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