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Export Provider Record NPI 1154668077
Lifespan Pharmacy, Llc
Organization Subpart: NO
Active
NPI Number1154668077
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1154668077
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2013-01-11
Last Updated2024-09-24
Authorized OfficialPeter Markel
EVP & CFO
Phone: 4014447914
Mailing Address593 Eddy St, Davol Building
Providence, RI 02903-4923
United States
Phone: (401) 444-4909 | Fax: (401) 444-2263
📍 View Map
Primary Practice Address593 Eddy St, Davol Building
Providence, RI 02903-4923
United States
Phone: (401) 444-4909 | Fax: (401) 444-2263
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMA110066635C-
Other (non-Medicare)MA2138499Medicaid
Other (non-Medicare)-2138499PK
MEDICAIDRILI92510-
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies--
No333600000X – Pharmacy--
Yes3336C0003X – Pharmacy, Community/Retail PharmacyRIPHA00549
No3336S0011X – Pharmacy, Specialty Pharmacy--
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About NPI 1154668077

Lifespan Pharmacy, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1154668077. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Providence, RI. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2013-01-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1154668077?

NPI 1154668077 belongs to Lifespan Pharmacy, Llc, a Pharmacy, Community/Retail Pharmacy in Providence, RI. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1154668077 active?

The current status of NPI 1154668077 in the NPPES registry is Active. The record was last updated on 2024-09-24.

What specialty is NPI 1154668077?

NPI 1154668077 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1154668077?

You can verify NPI 1154668077 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1154668077?

The primary practice address on file for NPI 1154668077 is 593 Eddy St, Providence, RI 02903-4923. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1154668077 issued?

NPI 1154668077 was first issued (enumerated) on 2013-01-11. The NPPES record was last updated on 2024-09-24.

Practice Location Map

Lifespan Pharmacy, Llc is located at 593 Eddy St, Providence, RI. Use the map below to find directions or verify the practice location.

📍 593 Eddy St, Providence, RI 02903-4923  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Lifespan Pharmacy, Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1154668077. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail PharmacyPHA00549RI
Data Verified from CMS NPPES Last synced: 2026-08-20 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162