Provider Demographics
NPI:1790949089
Name:KOWALSKY, RACHEL NICOLE
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:NICOLE
Last Name:KOWALSKY
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 1:4551 US HIGHWAY 80 W
Mailing Address - Street 2:
Mailing Address - City:TUSKEGEE
Mailing Address - State:AL
Mailing Address - Zip Code:36083-5428
Mailing Address - Country:US
Mailing Address - Phone:334-725-9102
Mailing Address - Fax:
Practice Address - Street 1:9505 VAUGHN RD
Practice Address - Street 2:
Practice Address - City:PIKE ROAD
Practice Address - State:AL
Practice Address - Zip Code:36064-2292
Practice Address - Country:US
Practice Address - Phone:334-277-1153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist