Provider Demographics
NPI:1366732489
Name:BLAIR, JOANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 VILLAGE PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1849
Mailing Address - Country:US
Mailing Address - Phone:401-934-2480
Mailing Address - Fax:401-934-2970
Practice Address - Street 1:47 VILLAGE PLAZA WAY
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1849
Practice Address - Country:US
Practice Address - Phone:401-934-2480
Practice Address - Fax:401-934-2970
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist