Healthcare Provider Details

I. General information

NPI: 1427382795
Provider Name (Legal Business Name): REBEKAH DIANE RUGGLES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEKAH DIANE PAULEY PHARMD

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 W INNES ST
SALISBURY NC
28144-2433
US

IV. Provider business mailing address

409 VINCENT CT
SALISBURY NC
28146-7078
US

V. Phone/Fax

Practice location:
  • Phone: 704-636-7479
  • Fax:
Mailing address:
  • Phone: 704-310-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17289
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: