Provider Demographics
NPI:1184404592
Name:RYALS, RACHEL LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:RYALS
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 1:20696 545TH ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-8415
Mailing Address - Country:US
Mailing Address - Phone:641-895-9958
Mailing Address - Fax:
Practice Address - Street 1:213 N 13TH ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1707
Practice Address - Country:US
Practice Address - Phone:641-437-7200
Practice Address - Fax:641-437-7300
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist