Provider Demographics
NPI:1265734172
Name:RACHEL-PRICE, CAROLYN (RPH)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:RACHEL-PRICE
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:#4 DC VILLAGE LANE, SW
Mailing Address - Street 2:DOH PHARMACEUTICAL WAREHOUSE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-5205
Mailing Address - Country:US
Mailing Address - Phone:202-645-5954
Mailing Address - Fax:202-645-5909
Practice Address - Street 1:4 DC VILLAGE LN SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-5205
Practice Address - Country:US
Practice Address - Phone:202-645-5954
Practice Address - Fax:202-645-5909
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH2198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC036001400Medicaid