Individual
JACOB DERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 QUAKER LN, WARWICK, RI 02886-0159
(401) 828-0533
Mailing address
137 MISHNOCK RD, WEST GREENWICH, RI 02817-1676
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PHL06062
RI
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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