Provider Demographics
NPI:1083489645
Name:WRAM, REBECCA DUNBAR (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DUNBAR
Last Name:WRAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 60TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7700
Mailing Address - Country:US
Mailing Address - Phone:515-343-1700
Mailing Address - Fax:515-343-1701
Practice Address - Street 1:1660 60TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7700
Practice Address - Country:US
Practice Address - Phone:515-343-1700
Practice Address - Fax:515-343-1701
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist