Provider Demographics
NPI:1245765932
Name:NORTH, REBECCA NICOLE (RPH)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:NICOLE
Last Name:NORTH
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 1:1585 GEORGESVILLE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-3777
Mailing Address - Country:US
Mailing Address - Phone:614-878-1664
Mailing Address - Fax:614-878-1785
Practice Address - Street 1:1585 GEORGESVILLE SQUARE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3777
Practice Address - Country:US
Practice Address - Phone:614-878-1664
Practice Address - Fax:614-878-1785
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist