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Individual

TELL D SACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPHT-ADV

Contact information

Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-3699
Mailing address
14 GEORGIANA DR, CUMBERLAND, RI 02864-1106

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PH202862
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1208299
PTCB
01
1439351
NABP
Enumeration date
05/23/2025
Last updated
05/23/2025
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