Healthcare Provider Details

I. General information

NPI: 1922645407
Provider Name (Legal Business Name): RACHEL ZOMERFELD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 PUBLIC SQ # 60
WILKES BARRE PA
18701-2610
US

IV. Provider business mailing address

25 CAYUGA PL
FORTY FORT PA
18704-5001
US

V. Phone/Fax

Practice location:
  • Phone: 570-284-3756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP449687
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: