MEDICARE: RACHEL L RAGER CPHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician	290101040751738	MI

General Provider Information

NPI Number	:	1700999562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL L RAGER CPHT

Provider Business Mailing Address
First Line	:	6065 MEEUWENBERG DR
Second Line	:
City	:	TWIN LAKE
State	:	MI
Zip	:	49457-9151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8744 FERRY ST
Second Line	:
City	:	MONTAGUE
State	:	MI
Zip	:	49437-1391
Country	:	US
Telephone Number	:	231-893-8255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/08/2007

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