Provider Demographics
NPI:1093252033
Name:GRIFFIE, REBECCA LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:GRIFFIE
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 1:1111 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5842
Mailing Address - Country:US
Mailing Address - Phone:903-424-5948
Mailing Address - Fax:
Practice Address - Street 1:1111 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5842
Practice Address - Country:US
Practice Address - Phone:903-424-5948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-29
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist