Provider Demographics
NPI:1639588072
Name:VAN HOVE, REBECCA LYN (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYN
Last Name:VAN HOVE
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 1:805 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7722
Mailing Address - Country:US
Mailing Address - Phone:301-371-4100
Mailing Address - Fax:301-371-8295
Practice Address - Street 1:805 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:MD
Practice Address - Zip Code:21769-7722
Practice Address - Country:US
Practice Address - Phone:301-371-4100
Practice Address - Fax:301-371-8295
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist