| Organization Name: | PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER,INC |
| NPI Number: | 1043343411 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK GILMORE (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 59 Sandy Bottom Rd Coventry |
| State: | RI US |
| Postal Code: | 028165863 |
| Phone Number: | 4018215000 |
| Fax Number: | 4018215016 |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | PHA00001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |