Provider Demographics
NPI:1649400631
Name:BLOYD, REBECCA BASSI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:BASSI
Last Name:BLOYD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9111
Mailing Address - Country:US
Mailing Address - Phone:336-584-3374
Mailing Address - Fax:336-584-0762
Practice Address - Street 1:3465 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-9111
Practice Address - Country:US
Practice Address - Phone:336-584-3374
Practice Address - Fax:336-584-0762
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist