Provider Demographics
NPI:1316987555
Name:RIOUX, PHILIP W (RPH)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:W
Last Name:RIOUX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7007
Mailing Address - Country:US
Mailing Address - Phone:207-795-2328
Mailing Address - Fax:207-795-2316
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7007
Practice Address - Country:US
Practice Address - Phone:207-795-2328
Practice Address - Fax:207-795-2316
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR2984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist