Provider Demographics
NPI:1972885879
Name:ROSA, ANNE MARIE (RPH)
Entity type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:ROSA
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 1:139 KENOZA ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4314
Mailing Address - Country:US
Mailing Address - Phone:978-771-1480
Mailing Address - Fax:978-945-6493
Practice Address - Street 1:70 PLEASANT VALLEY ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7288
Practice Address - Country:US
Practice Address - Phone:978-771-1480
Practice Address - Fax:978-945-6493
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH22573183500000X
NH2927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist