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General NPI Number Information
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NPI Number | 1184994626
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Entity Type | Individual
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Provider Name | TRACI BETH VREHAS RPH
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Gender | Female
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 02/13/2021
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Provider Practice Location Address
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Address Line | 8845 KENNEDY AVE
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City | HIGHLAND
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State | IN
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Zip | 46322-1908
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Country | US
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Telephone | 219-972-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 8845 KENNEDY AVE
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City | HIGHLAND
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State | IN
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Zip | 46322-1908
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Country | US
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Telephone | 219-972-1700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051289396
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2001030596
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS40602
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26026005A
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License Number State | IN
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