Provider Demographics
NPI:1487243119
Name:HARRISON, ANTHONY PETER III (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PETER
Last Name:HARRISON
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MODENA AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2012
Mailing Address - Country:US
Mailing Address - Phone:856-296-8788
Mailing Address - Fax:
Practice Address - Street 1:219 MANTON AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-3329
Practice Address - Country:US
Practice Address - Phone:401-351-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist