Provider Demographics
NPI:1124615281
Name:LEWIS, MARIA ANDREA (RPH)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANDREA
Last Name:LEWIS
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 1:120 MAXWELL RD
Mailing Address - Street 2:
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-9428
Mailing Address - Country:US
Mailing Address - Phone:413-427-7844
Mailing Address - Fax:
Practice Address - Street 1:672 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-5069
Practice Address - Country:US
Practice Address - Phone:413-593-3999
Practice Address - Fax:844-411-6203
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist