# LIFESPAN PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brown University Health Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104410935
- **Authorized official:** PETER K MARKELL (EVP & CFO)
- **Authorized official phone:** (401) 444-7914

## Contact information

- **Practice address:** 11 FRIENDSHIP STREET, SHEFFIELD BLDG., 1ST FLOOR, NEWPORT, RI 02840-0284
- **Practice address phone:** (401) 845-1100
- **Practice address fax:** (401) 845-1111
- **Mailing address:** 117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
- **Mailing address phone:** (401) 444-7914
- **Mailing address fax:** (401) 444-6912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/23/2021
- **Last updated:** 09/24/2024