Provider Demographics
NPI:1407841141
Name:RATH, KIMBERLY DENISE (PHARMD, CGP, FASCP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DENISE
Last Name:RATH
Suffix:
Gender:F
Credentials:PHARMD, CGP, FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 RIVERWOOD CRES
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2849
Mailing Address - Country:US
Mailing Address - Phone:757-204-4343
Mailing Address - Fax:757-282-5980
Practice Address - Street 1:3536 RIVERWOOD CRES
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-2849
Practice Address - Country:US
Practice Address - Phone:757-204-4343
Practice Address - Fax:757-282-5980
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022057761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy