Organization
CCR PHARMACY LLC
Active
Other names
JB Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL CAPUANO (PHARMACIST/OWNER)
(401) 861-1194
Entity
Organization
Contact information
Practice address
1165 MAIN AVE, WARWICK, RI 02886-1940
(401) 861-1194
(401) 383-7773
Mailing address
1165 MAIN AVE, WARWICK, RI 02886-1940
(401) 861-1194
(401) 383-7773
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHA00542
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169883
PK
—
05
—
JP68164
—
RI
Enumeration date
06/19/2017
Last updated
04/01/2025
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