Provider Demographics
NPI:1083995484
Name:PRESTON, RACHELLE KASSIDI (PHARMD)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:KASSIDI
Last Name:PRESTON
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 1:3413 BISON LN
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-3867
Mailing Address - Country:US
Mailing Address - Phone:406-899-8367
Mailing Address - Fax:
Practice Address - Street 1:1213 3RD ST NW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-4116
Practice Address - Country:US
Practice Address - Phone:406-761-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist