Provider Demographics
NPI:1144504937
Name:AINLEY, MOL T (RPH)
Entity type:Individual
Prefix:
First Name:MOL
Middle Name:T
Last Name:AINLEY
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 1:333 ATWELLS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1489
Mailing Address - Country:US
Mailing Address - Phone:401-276-8301
Mailing Address - Fax:401-276-8307
Practice Address - Street 1:333 ATWELLS AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1489
Practice Address - Country:US
Practice Address - Phone:401-276-8301
Practice Address - Fax:401-276-8307
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH03921183500000X
MAPH23721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist