Provider Demographics
NPI:1083253686
Name:PARAS, REBEKKAH JANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBEKKAH
Middle Name:JANE
Last Name:PARAS
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 1:3301 BEHR CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-3302
Mailing Address - Country:US
Mailing Address - Phone:812-760-3607
Mailing Address - Fax:
Practice Address - Street 1:2440 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2123
Practice Address - Country:US
Practice Address - Phone:502-459-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027845A183500000X
KY020123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist