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Organization
LIFESPAN PHARMACY, LLC
Active
Organization
LIFESPAN PHARMACY, LLC
Active
Other names
Brown University Health Pharmacy, Lifespan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PETER K MARKELL (EVP & CFO)
(401) 444-7914
Entity
Organization
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-5500
(401) 793-5601
Mailing address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-5500
(401) 793-5601
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHA00565
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146592
PK
—
05
—
LI00239
—
RI
Enumeration date
06/03/2014
Last updated
09/24/2024
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