Provider Demographics
NPI:1912500422
Name:PERRON, VIRGINIA MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MARIE
Last Name:PERRON
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 1:41 SHERIDAN LN
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1092
Mailing Address - Country:US
Mailing Address - Phone:978-807-2278
Mailing Address - Fax:
Practice Address - Street 1:41 SHERIDAN LN
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1092
Practice Address - Country:US
Practice Address - Phone:978-807-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist