Individual
ISSA ISSA MADHOUN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
085551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02142143
—
NY
Enumeration date
05/14/2011
Last updated
08/20/2021
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