Provider Demographics
NPI:1023322294
Name:LAFAR, REBECCA ELLEN (RPH)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:ELLEN
Last Name:LAFAR
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 1:918 HOUSTON NORTHCUTT BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3447
Mailing Address - Country:US
Mailing Address - Phone:843-884-5144
Mailing Address - Fax:
Practice Address - Street 1:918 HOUSTON NORTHCUTT BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3447
Practice Address - Country:US
Practice Address - Phone:843-884-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist