Basic Information
Provider Information
NPI: 1083601793
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CORNETT
FirstName: RACHEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 SW ARCHER RD
Address2: OUTPATIENT PHARMACY-119
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Practice Location
Address1: 1601 SW ARCHER RD
Address2: OUTPATIENT PHARMACY-119
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/29/2005
LastUpdateDate: 08/16/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X27569FLY Pharmacy Service ProvidersPharmacist 

No ID Information.


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