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Individual
JUSTIN M COSTA
Active
Individual
JUSTIN M COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH238590
MA
183500000X
Pharmacist
Primary
RPH05959
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH238590
MA BOARD OF PHARMACY
MA
01
—
RPH05959
RI BOARD OF PHARMACY
RI
Enumeration date
12/04/2018
Last updated
12/04/2018
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