Provider Demographics
NPI:1306941737
Name:BASKETT, RITA (RPH)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:BASKETT
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 1:2419 TARLETON TWINS TER
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-4426
Mailing Address - Country:US
Mailing Address - Phone:704-408-1744
Mailing Address - Fax:
Practice Address - Street 1:13034 BALLANTYNE CORPORATE PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-1498
Practice Address - Country:US
Practice Address - Phone:704-816-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14804183500000X
NJRI18385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist