Organization
SUBURBAN PHARMACY INC
Active
Other names
SUBURBAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS SHANOS RPH (OWNER AND PRESIDENT)
(401) 781-2110
Entity
Organization
Contact information
Practice address
242 PAWTUXET AVE, WARWICK, RI 02888-1933
(401) 781-2110
(401) 781-2640
Mailing address
242 PAWTUXET AVE, WARWICK, RI 02888-1933
(401) 781-2110
(401) 781-2640
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA00136
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2088084
PK
—
05
—
SP00071
—
RI
Enumeration date
02/15/2007
Last updated
12/03/2013
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