Green Line Supply LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

GREEN LINE SUPPLY LLC

Practice address

10 Tripps LN
Riverside, RI 02915-3014

Phone

(401) 360-3400

NPI assigned

Dec 6, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Procaccianti

Title

President

Phone

(401) 360-3200

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1386450153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MAIN ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRIPPS LN",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029153014",
            "telephone_number": "401-360-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LINE SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "PROCACCIANTI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-360-3200"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geetha Gopalakrishnan, MD
• Vidya Gopinath, M.D.
• Jennifer Goslin, RN
• Laurie J Grauel, MD
• Greater Providence Chapter,Riarc
• David M Greenberg, DPM
• Judith Greene, LICSW
• Veronica Grosse-Cardinale, PSYD
• Debra Gustafson, PHD
• Kate M Guthrie, PHD

• Long Term Care Pharmacy in Riverside, RI
• Providers in Riverside, RI by specialty
• Long Term Care Pharmacy in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.