Provider Demographics
NPI:1336375435
Name:RATHWAY, BECKY MORGAN
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:MORGAN
Last Name:RATHWAY
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 1:414 MILDRED RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-3872
Mailing Address - Country:US
Mailing Address - Phone:724-929-3374
Mailing Address - Fax:
Practice Address - Street 1:200 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-2654
Practice Address - Country:US
Practice Address - Phone:724-628-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035419L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist