Organization
PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER,INC
Active
Organization
PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER,INC
Active
Other names
Pawtuxet Valley InfusionCare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK GILMORE RPH (DIRECTOR OF OPERATIONS)
(401) 821-0600
Entity
Organization
Contact information
Practice address
85 SANDY BOTTOM RD, COVENTRY, RI 02816-5863
(401) 821-0600
(401) 823-7558
Mailing address
85 SANDY BOTTOM RD, COVENTRY, RI 02816-5863
(401) 821-0600
(401) 823-7558
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHA00010
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4104989
NABP #
RI
01
—
58225
BLUE CROSS #
RI
05
—
PV05379
—
RI
05
—
PV07288
—
RI
05
—
PV52305
—
RI
Enumeration date
03/14/2007
Last updated
03/07/2023
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