Provider Demographics
NPI:1013356138
Name:SMITH, RACHEL DOROTHEA (PHARMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DOROTHEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 N POINDEXTER ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4055
Mailing Address - Country:US
Mailing Address - Phone:252-267-0236
Mailing Address - Fax:
Practice Address - Street 1:119 U.S. HIGHWAY 13 BYPASS
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983
Practice Address - Country:US
Practice Address - Phone:252-794-9299
Practice Address - Fax:252-794-3655
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist