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Organization
PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER,INC
Active
Organization
PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER,INC
Active
Other names
Pawtuxet Valley Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GILMORE RPH (DIRECTOR OF OPERATIONS)
(401) 821-0600
Entity
Organization
Contact information
Practice address
65 SANDY BOTTOM RD, COVENTRY, RI 02816-5863
(401) 823-9400
(410) 822-0262
Mailing address
65 SANDY BOTTOM RD, COVENTRY, RI 02816-5863
(401) 823-9400
(410) 822-0262
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHA00001
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4103406
NCPDP
RI
01
—
PHA00001
LICENSE #
RI
Enumeration date
03/14/2007
Last updated
03/07/2023
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