Provider Demographics
NPI:1346524188
Name:JANG, RACHEL M (PHARMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:JANG
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 1:13926 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2415
Mailing Address - Country:US
Mailing Address - Phone:703-259-6200
Mailing Address - Fax:
Practice Address - Street 1:13926 LEE HWY
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-2415
Practice Address - Country:US
Practice Address - Phone:703-259-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist