Provider Demographics
NPI:1437750775
Name:LAWSON, REBECCA DIANE (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DIANE
Last Name:LAWSON
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 1:14501 HANCOCK VILLAGE ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2776
Mailing Address - Country:US
Mailing Address - Phone:804-739-1668
Mailing Address - Fax:804-739-4622
Practice Address - Street 1:14501 HANCOCK VILLAGE ST
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-2776
Practice Address - Country:US
Practice Address - Phone:804-739-1668
Practice Address - Fax:804-739-4622
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist