Basic Information
| Provider Information | |||||||||
| NPI: | 1205365095 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMOND | ||||||||
| FirstName: | AUDREY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RPH | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2 HEMINGWAY DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029152224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014319020 | ||||||||
| FaxNumber: | 4014342026 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 HEMINGWAY DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029152224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014319020 | ||||||||
| FaxNumber: | 4014342026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 3272 | RI | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.