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General NPI Number Information
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NPI Number | 1750980751
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Entity Type | Individual
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Provider Name | RACHEL DIVINCENZO PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 11300 CORNELL PARK DR
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City | BLUE ASH
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State | OH
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Zip | 45242-1814
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Country | US
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Telephone | 513-387-1484
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Fax | 513-387-1470
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Provider Business Mailing Address
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Address Line | 4368 N MALLARD CV
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City | MASON
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State | OH
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Zip | 45040-9039
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Country | US
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Telephone | 859-992-6372
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0015151
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 015108
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | S021748
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 03230529
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License Number State | OH
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