Provider Demographics
NPI:1578670683
Name:RHODES, LANCE EVERETT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:EVERETT
Last Name:RHODES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 TURKEY NECK RD
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:MD
Mailing Address - Zip Code:21561-1151
Mailing Address - Country:US
Mailing Address - Phone:301-387-2931
Mailing Address - Fax:301-533-4102
Practice Address - Street 1:251 N 4TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1375
Practice Address - Country:US
Practice Address - Phone:301-533-4101
Practice Address - Fax:301-533-4102
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist