OrganizationActive
Pawtuxet Valley Prescription & Surgical Center,inc
NPI 1043343411 · Compounding Pharmacy · Coventry, RI
Provider details
- NPI number
- 1043343411
- Entity type
- Organization
- Primary specialty
- Compounding PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Mark Gilmore, Director of Operations(401) 821-0600
- License
- PHA00001 (RI)
Specialties & taxonomies
Suppliers
Practice location
59 Sandy Bottom Rd
Coventry, RI 02816-5863
Phone: (401) 821-5000
Fax: (401) 821-5016
Approximate (ZIP-level) locationGet directions
Mailing address
59 Sandy Bottom Rd
Coventry, RI 02816-5863
Other names (DBA / former)
- Other name
- Pawtuxet Valley Compound Lab
Registry dates
- Enumerated
- 2007-03-14
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.