MEDICARE: MRS. RITA DELENE LEWIS RPH

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	1835P1300X	Psychiatric Pharmacist	9333	VA

General Provider Information

NPI Number	:	1992705479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RITA DELENE LEWIS RPH

Provider Business Mailing Address
First Line	:	11 S LYNNHAVEN DR
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-2260
Country	:	US
Telephone Number	:	540-332-8041
Fax Number	:	540-332-8044

Provider Business Practice Location Address
First Line	:	1301 RICHMOND AVE
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-9146
Country	:	US
Telephone Number	:	540-332-8041
Fax Number	:	540-332-8044

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

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	07/08/2007

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