Basic Information
Provider Information
NPI: 1467999128
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRITT
FirstName: RACHEL
MiddleName: BOOKER
NamePrefix:  
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 508 FULTON ST # 119
Address2:  
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber:  
Practice Location
Address1: 508 FULTON ST # 119
Address2:  
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/19/2017
LastUpdateDate: 01/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X23464NCY Pharmacy Service ProvidersPharmacist 

No ID Information.


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