Provider Demographics
NPI:1629181193
Name:ATWOOD PRESCRIPTION CENTER INC.
Entity type:Organization
Organization Name:ATWOOD PRESCRIPTION CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:ROBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:401-831-0100
Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-831-0100
Mailing Address - Fax:401-453-3794
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-831-0100
Practice Address - Fax:401-453-3794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPHA00077332B00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAP02328Medicaid
RI4100993OtherNABP#
RI4100993OtherNABP#
RI4100993OtherNABP#