Organization
GREEN LINE SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH PROCACCIANTI (PRESIDENT)
(401) 360-3200
Entity
Organization
Contact information
Practice address
10 TRIPPS LN, RIVERSIDE, RI 02915-3014
(401) 360-3400
Mailing address
203 MAIN ST, WAKEFIELD, RI 02879-3557
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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