Provider Demographics
NPI:1447824123
Name:AYERS, JUDY J
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:J
Last Name:AYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1993 PLAINFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-5707
Mailing Address - Country:US
Mailing Address - Phone:401-942-3286
Mailing Address - Fax:401-942-3785
Practice Address - Street 1:1993 PLAINFIELD PIKE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-5707
Practice Address - Country:US
Practice Address - Phone:401-942-3286
Practice Address - Fax:401-942-3785
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist