MEDICARE: KELLY GAIL RACEK PHARMD

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
1	183500000X	Pharmacist	26024736A	IN

General Provider Information

NPI Number	:	1851937767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY GAIL RACEK PHARMD

Provider Business Mailing Address
First Line	:	1217 E IRELAND RD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46614-3448
Country	:	US
Telephone Number	:	574-291-0740
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 E IRELAND RD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46614-3448
Country	:	US
Telephone Number	:	574-291-0740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2019
Last Update Date	:	11/26/2019

Similar Medicare Providers

1568454940 — SHERI A WILSON PA-C
Practice Location Address:

1245 E IRELAND RD
SOUTH BEND, IN
46614-3448

Practice Phone: 743-127-0225
Practice Fax:

1588737100 — KROGER LIMITED PARTNERSHIP I
Practice Location Address:

1217 E IRELAND RD
SOUTH BEND, IN
46614-3448

Practice Phone: 574-291-0740
Practice Fax: 574-299-4314

1700423563 — MS. LINDA RENEE SIMMONS
Practice Location Address:

1217 E IRELAND RD
SOUTH BEND, IN
46614-3448

Practice Phone: 574-291-0666
Practice Fax:

1962123075 — KRISTINA MARIE CRESPO PA-C
Practice Location Address:

1245 E IRELAND RD
SOUTH BEND, IN
46614-3448

Practice Phone: 574-312-7022
Practice Fax:

1396684767 — DR. DELYN MOUA DC
Practice Location Address:

4753 FIRESTONE BLVD
SOUTH GATE, CA
90280-3448

Practice Phone: 323-310-2217
Practice Fax:

1245357607 — SANDRA MCCLENDON CUMMINGS LLMSW
Practice Location Address:

5555 CONNER ST , SUITE 1000 SOUTH
DETROIT, MI
48213-3448

Practice Phone: 313-347-2067
Practice Fax:

Directions to “ KELLY GAIL RACEK PHARMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.