1417596792 NPI number — CARE NEW ENGLAND PHARMACY LLC

Table of content: (NPI 1417596792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417596792 NPI number — CARE NEW ENGLAND PHARMACY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE NEW ENGLAND PHARMACY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417596792
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
626 TOLL GATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-2717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-921-7525
Provider Business Mailing Address Fax Number:
401-921-3041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 TOLL GATE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARWICK
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02886-2759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-981-1908
Provider Business Practice Location Address Fax Number:
401-889-5050
Provider Enumeration Date:
01/03/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IANNONI
Authorized Official First Name:
JOESPH
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP/CFO
Authorized Official Telephone Number:
401-921-7525

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)