Provider Demographics
NPI:1053608679
Name:CULLIGAN, MARCIA D (RPH)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:D
Last Name:CULLIGAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ECHO DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-2808
Mailing Address - Country:US
Mailing Address - Phone:401-245-0771
Mailing Address - Fax:
Practice Address - Street 1:345 BLACKSTONE BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4800
Practice Address - Country:US
Practice Address - Phone:401-455-6316
Practice Address - Fax:401-455-6300
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI03289183500000X
CT6489183500000X
MA25398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist