Healthcare Provider Details

I. General information

NPI: 1790777274
Provider Name (Legal Business Name): RACHEL ROBERTS OGDEN RPH, CGP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 1/2 S BROAD ST
GROVE CITY PA
16127-1503
US

IV. Provider business mailing address

PO BOX 164
GROVE CITY PA
16127-0164
US

V. Phone/Fax

Practice location:
  • Phone: 724-458-6545
  • Fax: 724-458-8892
Mailing address:
  • Phone: 724-992-0293
  • Fax: 724-458-8892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034831L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: