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Organization
SUBURBAN PHARMACY INC
Active
Organization
SUBURBAN PHARMACY INC
Active
Other names
SUBURBAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS SHANOS RPH (OWNER AND PRESIDENT)
(401) 781-2110
Entity
Organization
Contact information
Practice address
242 PAWTUXET AVE, WARWICK, RI 02888-1933
(401) 781-2110
(401) 781-2640
Mailing address
242 PAWTUXET AVE, WARWICK, RI 02888-1933
(401) 781-2110
(401) 781-2640
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHA00136
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2088084
PK
—
05
—
SP00071
—
RI
Enumeration date
02/15/2007
Last updated
12/03/2013
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