1700277175 NPI number — DR. RAYMOND CHRISTOPHER DURIGAN III PHARMD,BCPS

Table of content: DR. RAYMOND CHRISTOPHER DURIGAN III PHARMD,BCPS (NPI 1700277175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700277175 NPI number — DR. RAYMOND CHRISTOPHER DURIGAN III PHARMD,BCPS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DURIGAN
Provider First Name:
RAYMOND
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
PHARMD,BCPS
Provider Gender Code:
M

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:
1700277175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
128 HOPE HILL TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRANSTON
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02921-2729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-225-4994
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 CLINTON ST
Provider Second Line Business Practice Location Address:
THUNDERMIST HEALTH CENTER
Provider Business Practice Location Address City Name:
WOONSOCKET
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02895-3207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-767-4000
Provider Business Practice Location Address Fax Number:
401-235-6893
Provider Enumeration Date:
02/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  RP449025 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P2201X , with the licence number: RPH05636 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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