Provider Demographics
NPI:1578017828
Name:BOCK, REBECCA (RPH)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:BOCK
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 1:5013 LEGENDS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-3460
Mailing Address - Country:US
Mailing Address - Phone:717-446-1821
Mailing Address - Fax:
Practice Address - Street 1:250 TURNER ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2363
Practice Address - Country:US
Practice Address - Phone:910-695-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist