LIFESPAN PHARMACY, LLC (NPI# 1295148625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295148625 |
| Entity Type | Organization |
| Organization Name | LIFESPAN PHARMACY, LLC |
| Other Organization Name | LIFESPAN PHARMACY |
| Practice Address |
164 Summit Ave Providence RI 02906-2853 |
| Practice Telephone | 4017935500 |
| Practice Fax Number | 4017935601 |
| Mailing Telephone | 4017935500 |
| Mailing Fax Number | 4017935601 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2018-12-27 |
| Authorized Official Name | MARY A WAKEFIELD (TREASURER) |
| Authorized Official Telephone | 4014447093 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHA00565 | RI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146592 | 01 | |
| RI | LI00239 | 05 |
| Other Name | Type Code |
|---|---|
| Lifespan Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629622634 | Lifespan Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 117 Chapman St Ste 200, Providence, RI 02905-5400 | 2019-07-29 |
| 1154668077 | Lifespan Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 593 Eddy St, Davol Building, Providence, RI 02903-4923 | 2013-01-11 |
| Street Address |
164 SUMMIT AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558369512 | Josephine Salhab | Physician Assistant | 164 Summit Ave, Rm C70, Providence, RI 02906-2853 | 2005-07-13 |
| 1619519865 | Sarah Mcnerney | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2019-10-09 |
| 1831743095 | Tracy Lynn Carraggi | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2853 | 2019-07-26 |
| 1689233975 | Nicole Parascandolo | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2894 | 2019-06-10 |
| 1164992558 | Lisha Andrew | Dietitian, Registered | 164 Summit Ave, Providence, RI 02906-2894 | 2018-11-28 |
| 1689156242 | Monique Coley | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2894 | 2018-08-30 |
| 1235615006 | Sameh Mohamed | Internal Medicine | 164 Summit Ave, Providence, RI 02906-2894 | 2018-07-16 |
| 1578058087 | Noor N Safadi | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2018-06-27 |
| 1356847172 | Heidi Jimenez | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-04-02 |
| 1831694439 | Laura Canavan | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292167 | 3bc Incorporated | Pharmacy | 435 North Gateway Drive #802, Providence, UT 84332 | 2020-10-09 |
| 1336705755 | Bear Lake Community Health Center | Pharmacy | 517 W 100 N Ste 210, Providence, UT 84332-9826 | 2019-05-10 |
| 1568949683 | Allcare Rx Solutions LLC | Pharmacy | 265 Waterman St, Providence, RI 02906-5127 | 2018-07-21 |
| 1952854903 | Rite Aid Pharmacy | Pharmacy | 412 Angell St, Apartment 2, Providence, RI 02906-4013 | 2016-07-26 |
| 1750564514 | South Valley Pharmacy | Pharmacy | 1652 S Highway 165, Providence, UT 84332-6701 | 2007-12-14 |
| 1518153014 | Ccr Pharmacy LLC | Pharmacy | 1017 Smith St, Providence, RI 02908-2747 | 2007-09-18 |
| 1558495457 | Maceys Inc | Pharmacy | 50 North Highway 165, Providence, UT 84332 | 2007-03-15 |
| 1679621676 | Prime Drug Inc | Pharmacy | 613 Cranston St, Providence, RI 02907-2813 | 2007-01-08 |
| 1528144128 | Genter's Pharmacy Corp | Pharmacy | 866 Broad St, Providence, RI 02907-1724 | 2006-10-27 |
| 1093819898 | Rhode Island Cvs Pharmacy, L.L.C. | Pharmacy | 960 Broad St, Providence, RI 02905-1822 | 2006-09-12 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.