Provider Demographics
NPI:1366551186
Name:RAPACKE, JOHN H (PHARM-D)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:RAPACKE
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4976 NE TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-9792
Mailing Address - Country:US
Mailing Address - Phone:607-664-4469
Mailing Address - Fax:607-664-4478
Practice Address - Street 1:76 VETERANS AVE, PHARMACY SERVICE
Practice Address - Street 2:D&T/119/76/160
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810
Practice Address - Country:US
Practice Address - Phone:607-664-4469
Practice Address - Fax:607-664-4478
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029648-11835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy