Provider Demographics
NPI:1124438486
Name:KING, RACHEL (RPH)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27967 BLUEBIRD DR
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:MI
Mailing Address - Zip Code:48134-4700
Mailing Address - Country:US
Mailing Address - Phone:734-347-0005
Mailing Address - Fax:
Practice Address - Street 1:14640 PARDEE RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4739
Practice Address - Country:US
Practice Address - Phone:734-374-4233
Practice Address - Fax:734-374-4265
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020309061835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy