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General NPI Number Information
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NPI Number | 1508463381
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Entity Type | Individual
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Provider Name | DOROTHY RASNICK
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Gender | Female
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 265 MARKET ST
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City | NORTH TAZEWELL
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State | VA
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Zip | 24630-5015
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Country | US
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Telephone | 276-988-6593
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Fax |
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Provider Business Mailing Address
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Address Line | 121 STRATFORD LN
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City | NORTH TAZEWELL
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State | VA
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Zip | 24630-8577
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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 | RP0011389
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License Number State | WV
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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 | 0202213967
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License Number State | VA
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