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General NPI Number Information
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NPI Number | 1417550799
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Entity Type | Individual
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Provider Name | REBECCA ALINE FLANNAGAN RPH
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Gender | Female
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 3001 VIRGINIA AVE
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City | COLLINSVILLE
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State | VA
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Zip | 24078-2244
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Country | US
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Telephone | 276-647-3886
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4642
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City | MARTINSVILLE
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State | VA
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Zip | 24115-4642
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Country | US
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Telephone |
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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 | 14553
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License Number State | NC
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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 | 0202007775
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License Number State | VA
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