Provider Demographics
NPI:1083487045
Name:BOSWORTH, REBECCA ELEANOR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ELEANOR
Last Name:BOSWORTH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:ELEANOR
Other - Last Name:GUISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2920 GEORGIA AVE NW UNIT 401
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-5199
Mailing Address - Country:US
Mailing Address - Phone:925-548-7738
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:DIVISION OF PHARMACY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-476-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH2000044081835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatrics