Provider Demographics
NPI:1043328859
Name:OLIVER, ERNEST J (CDOE,RPH)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:J
Last Name:OLIVER
Suffix:
Gender:M
Credentials:CDOE,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 DEBORA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4651
Mailing Address - Country:US
Mailing Address - Phone:508-695-2890
Mailing Address - Fax:
Practice Address - Street 1:106 DEBORA RD
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4651
Practice Address - Country:US
Practice Address - Phone:508-695-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI02131183500000X
MA20130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist