# BROWN UNIVERSITY OF PROVEDENCE STATE OF RI AND PROV PLANTAIO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BROWN UNIVERSITY STUDENT HEALTH CENTER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629013149
- **Authorized official:** PAUL BERGERON (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (401) 863-7882

## Contact information

- **Practice address:** 450 BROOK STREET, PROVIDENCE, RI 02912-9006
- **Practice address phone:** (401) 863-7882
- **Practice address fax:** (401) 863-2178
- **Mailing address:** 13 BROWN ST, PROVIDENCE, RI 02912-9006
- **Mailing address phone:** (401) 863-7882
- **Mailing address fax:** (401) 863-2178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 09/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2088775 | PK | — |