Provider Demographics
NPI:1760193635
Name:SOMMERVILLE, RUSH LACHLAN PETER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RUSH
Middle Name:LACHLAN PETER
Last Name:SOMMERVILLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5799 W ILLIANA DR
Mailing Address - Street 2:
Mailing Address - City:WEST TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47885-9002
Mailing Address - Country:US
Mailing Address - Phone:812-870-5836
Mailing Address - Fax:
Practice Address - Street 1:5555 S US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4715
Practice Address - Country:US
Practice Address - Phone:812-299-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029437A183500000X
KY022578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist