Organization
GREEN LINE APOTHECARY LLC
Active
Other names
Green Line Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA PROCACCIANTI PHARMD (OWNER, PIC, AO)
(401) 360-3200
Entity
Organization
Contact information
Practice address
245 MAIN ST, WAKEFIELD, RI 02879-3527
(401) 360-3300
(401) 783-0045
Mailing address
245 MAIN ST, WAKEFIELD, RI 02879-3527
(401) 360-3200
(401) 783-0045
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA00608
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2156025
PK
—
Enumeration date
12/11/2015
Last updated
09/10/2021
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