Healthcare Provider Details

I. General information

NPI: 1508273442
Provider Name (Legal Business Name): RACHEL POPPEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2014
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W ELM AVE
POCAHONTAS IA
50574-1439
US

IV. Provider business mailing address

701 W ELM AVE
POCAHONTAS IA
50574-1439
US

V. Phone/Fax

Practice location:
  • Phone: 712-335-3119
  • Fax: 712-335-4145
Mailing address:
  • Phone: 712-335-3119
  • Fax: 712-335-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21700
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: