Provider Demographics
NPI:1639160567
Name:RAYFIELD, SEVERN THOMAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:SEVERN
Middle Name:THOMAS
Last Name:RAYFIELD
Suffix:
Gender:M
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:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:NASSAWADOX
Mailing Address - State:VA
Mailing Address - Zip Code:23413-0213
Mailing Address - Country:US
Mailing Address - Phone:757-442-6159
Mailing Address - Fax:
Practice Address - Street 1:2 FIG ST
Practice Address - Street 2:
Practice Address - City:CAPE CHARLES
Practice Address - State:VA
Practice Address - Zip Code:23310-3342
Practice Address - Country:US
Practice Address - Phone:757-331-1212
Practice Address - Fax:757-331-1306
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist