Provider Demographics
NPI:1194167411
Name:TRAYWICK, REBECCA A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:A
Last Name:TRAYWICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 MISSY LN
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-2882
Mailing Address - Country:US
Mailing Address - Phone:205-227-8981
Mailing Address - Fax:
Practice Address - Street 1:5150 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3635
Practice Address - Country:US
Practice Address - Phone:205-815-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist