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General NPI Number Information
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NPI Number | 1174870695
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Entity Type | Organization
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Legal Business Name | REHOBOTH PHARMACY INC
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 2616 PHILADELPHIA PIKE STE B UNIT B
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City | CLAYMONT
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State | DE
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Zip | 19703-2520
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Country | US
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Telephone | 302-798-8900
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Fax | 302-798-8100
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Provider Business Mailing Address
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Address Line | 2616 PHILADELPHIA PIKE STE B UNIT B
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City | CLAYMONT
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State | DE
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Zip | 19703-2520
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Country | US
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Telephone | 302-798-8900
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Fax | 302-798-8100
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Authorized Official
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Title or Position | PHARMACY MANANGER
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Name | NWAKAEGO CHUKWUNENYE
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Credential | MBA, PHARMD
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Telephone | 302-798-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | A3-000952
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License Number State | DE
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