Individual
COURTNEY COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 ATWOOD AVE, CRANSTON, RI 02920-4053
(401) 944-2669
Mailing address
200 ATWOOD AVE, CRANSTON, RI 02920-4053
(401) 944-2669
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
04255
RI
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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