Individual
EDWARD JOHN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 457-3048
Mailing address
161 CURTIS ST, CRANSTON, RI 02920-1823
(401) 440-9695
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
04216
RI
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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