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NPI Code Detail

MEDICARE: DR. KATHRYN REBECCA DEVIZIA PHARM.D.

MEDICARE: DR. KATHRYN REBECCA DEVIZIA PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist16905NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1361924025OTHERNCTAX ID

General Provider Information

NPI Number : 1134456098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHRYN REBECCA DEVIZIA PHARM.D.
Provider Business Mailing Address
First Line : 3911 CAPITAL BLVD
Second Line :
City : RALEIGH
State : NC
Zip : 27604-3411
Country : US
Telephone Number : 919-872-5233
Fax Number :
Provider Business Practice Location Address
First Line : 3911 CAPITAL BLVD
Second Line :
City : RALEIGH
State : NC
Zip : 27604-3411
Country : US
Telephone Number : 919-872-5233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2009
Last Update Date : 11/12/2009

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