Provider Demographics
NPI:1255764031
Name:RASZKA, BRIAN TIMOTHY (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TIMOTHY
Last Name:RASZKA
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 ORANGE HILL CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-6983
Mailing Address - Country:US
Mailing Address - Phone:908-313-1071
Mailing Address - Fax:
Practice Address - Street 1:105 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-9543
Practice Address - Country:US
Practice Address - Phone:704-434-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist