Provider Demographics
NPI:1518507243
Name:DEY, REBECCA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:DEY
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 1:1101 VISTA VIEW LN APT 208
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3145
Mailing Address - Country:US
Mailing Address - Phone:434-251-8638
Mailing Address - Fax:
Practice Address - Street 1:2770 LEWISVILLE CLEMMONS RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8716
Practice Address - Country:US
Practice Address - Phone:336-766-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist