Organization Name: | LIFESPAN PHARMACY LLC |
NPI Number: | 1154668077 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY WAKEFIELD (TREASURER, LIFESPAN PHARMACY) |
Mailing Address: | 593 Eddy St Davol Building Providence |
State: | RI US |
Postal Code: | 029034923 |
Phone Number: | 4014444909 |
Fax Number: | 4014442263 |
NPI Enumeration Date: | 01/11/2013 |
NPI Last Update Date: | 02/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |