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Individual
TINA M SMALL
Active
Individual
TINA M SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RI26065
NJ
183500000X
Pharmacist
Primary
RP041390L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI26065
RPH STATE LICENSE NUMBER
NJ
01
—
RP041390L
RPH STATE LICENSE NUMBER
PA
Enumeration date
03/05/2008
Last updated
03/05/2008
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