Provider Demographics
NPI:1619350196
Name:NEMECHEK, REBECCA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:NEMECHEK
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 1:915 CENTRE AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6045
Mailing Address - Country:US
Mailing Address - Phone:970-494-2140
Mailing Address - Fax:970-494-2131
Practice Address - Street 1:915 CENTRE AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6045
Practice Address - Country:US
Practice Address - Phone:970-494-2140
Practice Address - Fax:970-494-2131
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0014843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist