Provider Demographics
NPI:1194328047
Name:SOUSA, DEBBIE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:SOUSA
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BROOKFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01535-1409
Mailing Address - Country:US
Mailing Address - Phone:508-867-4891
Mailing Address - Fax:508-867-4896
Practice Address - Street 1:5 GILBERT ST
Practice Address - Street 2:
Practice Address - City:NORTH BROOKFIELD
Practice Address - State:MA
Practice Address - Zip Code:01535-1409
Practice Address - Country:US
Practice Address - Phone:508-867-4891
Practice Address - Fax:508-867-4896
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-00844183500000X
RIRPH06040183500000X
CTPCT.0014737183500000X
MAPH238254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist