Healthcare Provider Details

I. General information

NPI: 1013356138
Provider Name (Legal Business Name): RACHEL DOROTHEA SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 06/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 U.S. HIGHWAY 13 BYPASS
WINDSOR NC
27983
US

IV. Provider business mailing address

803 N POINDEXTER ST
ELIZABETH CITY NC
27909-4055
US

V. Phone/Fax

Practice location:
  • Phone: 252-794-9299
  • Fax: 252-794-3655
Mailing address:
  • Phone: 252-267-0236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23353
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: