Provider Demographics
NPI:1417246208
Name:WELCH, REBECCA ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANN
Last Name:WELCH
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 1:39 E MAY ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-1921
Mailing Address - Country:US
Mailing Address - Phone:770-867-2525
Mailing Address - Fax:770-867-8655
Practice Address - Street 1:39 E MAY ST
Practice Address - Street 2:SUITE I
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-1921
Practice Address - Country:US
Practice Address - Phone:770-867-2525
Practice Address - Fax:770-867-8655
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist