# GREEN LINE APOTHECARY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Green Line Apothecary
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023483336
- **Authorized official:** CHRISTINA PROCACCIANTI PHARMD (OWNER, PIC, AO)
- **Authorized official phone:** (401) 360-3200

## Contact information

- **Practice address:** 245 MAIN ST, WAKEFIELD, RI 02879-3527
- **Practice address phone:** (401) 360-3300
- **Practice address fax:** (401) 783-0045
- **Mailing address:** 245 MAIN ST, WAKEFIELD, RI 02879-3527
- **Mailing address phone:** (401) 360-3200
- **Mailing address fax:** (401) 783-0045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHA00608 | RI | Yes |

## Other

- **Enumeration date:** 12/11/2015
- **Last updated:** 09/10/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2156025 | PK | — |