Provider Demographics
NPI:1992084065
Name:COUTURE, JANICE T (RPH)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:T
Last Name:COUTURE
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 1:250 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:WINCHENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01475-1403
Mailing Address - Country:US
Mailing Address - Phone:978-297-3247
Mailing Address - Fax:
Practice Address - Street 1:250 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WINCHENDON
Practice Address - State:MA
Practice Address - Zip Code:01475-1403
Practice Address - Country:US
Practice Address - Phone:978-297-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist