Provider Demographics
NPI:1770189730
Name:NEILL, RACHEL DOLORES
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DOLORES
Last Name:NEILL
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 1:16641 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-2660
Mailing Address - Country:US
Mailing Address - Phone:804-883-5668
Mailing Address - Fax:804-381-4254
Practice Address - Street 1:16641 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2660
Practice Address - Country:US
Practice Address - Phone:804-883-5668
Practice Address - Fax:804-381-4254
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist