Provider Demographics
NPI:1407405970
Name:PENSE REHKOP, CHELSEA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:PENSE REHKOP
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 1:1092 MADISON 228
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:63645-8239
Mailing Address - Country:US
Mailing Address - Phone:573-783-9750
Mailing Address - Fax:
Practice Address - Street 1:1025 WALTON DR
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645-7235
Practice Address - Country:US
Practice Address - Phone:573-783-9750
Practice Address - Fax:573-783-8003
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist