Jessica Angeloro

Individual provider Active NPI Pharmacist · Coventry, RI

NPI 1366046989 · NPPES record last updated Nov 24, 2020

Key facts

NPI
1366046989
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RPH04590 (RI)
Practice address
763 Tiogue Ave
Coventry, RI 02816-5805
Phone
(401) 821-2060
NPI assigned
Nov 24, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RPH04590RIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island CVS Pharmacy LLC Past
since Nov 29, 2020
Accepting new patients
Rhode Island CVS Pharmacy, L.L.C. Past
since Nov 29, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH04590 RI Yes

Addresses

Primary practice location

763 Tiogue Ave
Coventry, RI 02816-5805

Mailing address

763 Tiogue Ave
Coventry, RI 02816-5805
Phone (401) 821-2060

Other providers in Coventry, RI

All providers in Coventry, RI · Pharmacist in Rhode Island

Sources for this page

Verify at the official NPI Registry.