Provider Demographics
NPI:1083141246
Name:BREWER, RACHAEL DAWN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:DAWN
Last Name:BREWER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:DAWN
Other - Last Name:DEWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640
Mailing Address - Country:US
Mailing Address - Phone:740-286-6400
Mailing Address - Fax:740-286-4510
Practice Address - Street 1:530 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640
Practice Address - Country:US
Practice Address - Phone:740-286-6400
Practice Address - Fax:740-286-4510
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03135551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist