Healthcare Provider Details

I. General information

NPI: 1578875415
Provider Name (Legal Business Name): KIMBERLY A RATHBONE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 FORT EDDY RD
CONCORD NH
03301-7404
US

IV. Provider business mailing address

4 TERRACE HILL RD
BOW NH
03304-4432
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-7785
  • Fax:
Mailing address:
  • Phone: 603-228-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2535
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: