Provider Demographics
NPI:1619367133
Name:SWEET, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:SWEET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 SUNBURST DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-8202
Mailing Address - Country:US
Mailing Address - Phone:919-778-1521
Mailing Address - Fax:919-429-5517
Practice Address - Street 1:1204 SUNBURST DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-8202
Practice Address - Country:US
Practice Address - Phone:919-778-1521
Practice Address - Fax:919-429-5517
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29354183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician