Provider Demographics
NPI:1841634375
Name:RHINE, HEATHER A (PHARMD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:RHINE
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 1:400 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-8827
Mailing Address - Country:US
Mailing Address - Phone:970-547-9343
Mailing Address - Fax:970-453-3877
Practice Address - Street 1:400 N PARK AVE
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-8827
Practice Address - Country:US
Practice Address - Phone:970-547-9343
Practice Address - Fax:970-453-3877
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist