Healthcare Provider Details

I. General information

NPI: 1689806366
Provider Name (Legal Business Name): RACHEL LARAE BOONE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL LARAE BARNES PHARM.D.

II. Dates (important events)

Enumeration Date: 08/14/2009
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 DEXTER L WOODS MEMORIAL BLVD
WAYNESBORO TN
38485-2416
US

IV. Provider business mailing address

119 S MILL ST P.O. BOX 629
LINDEN TN
37096-6457
US

V. Phone/Fax

Practice location:
  • Phone: 931-722-5466
  • Fax: 931-722-9495
Mailing address:
  • Phone: 931-589-2146
  • Fax: 931-589-2890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33595
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: