Provider Demographics
NPI:1477721694
Name:RHOADS, BRENT W (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:W
Last Name:RHOADS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 ROUTE 378
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-5432
Mailing Address - Country:US
Mailing Address - Phone:610-691-8179
Mailing Address - Fax:
Practice Address - Street 1:3691 ROUTE 378
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-5432
Practice Address - Country:US
Practice Address - Phone:610-691-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP025679L183500000X
MD12035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist