Provider Demographics
NPI:1215206131
Name:RAINEY, DENISE (PHARM D)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RAINEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9334 BENNINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-5044
Mailing Address - Country:US
Mailing Address - Phone:937-308-5694
Mailing Address - Fax:
Practice Address - Street 1:1542 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-1708
Practice Address - Country:US
Practice Address - Phone:937-254-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist