Healthcare Provider Details

I. General information

NPI: 1851938583
Provider Name (Legal Business Name): RACHEL COVINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 OLIO RD
FISHERS IN
46037-7618
US

IV. Provider business mailing address

11700 OLIO RD
FISHERS IN
46037-7618
US

V. Phone/Fax

Practice location:
  • Phone: 317-598-8515
  • Fax: 317-598-8517
Mailing address:
  • Phone: 317-598-8515
  • Fax: 317-598-8517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26025504A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: