Provider Demographics
NPI:1396145512
Name:WOODWORTH, RACHEL (PHARM D)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WOODWORTH
Suffix:
Gender:F
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 1:1725 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8851
Mailing Address - Country:US
Mailing Address - Phone:970-663-1962
Mailing Address - Fax:970-776-5596
Practice Address - Street 1:1725 ROCKY MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8851
Practice Address - Country:US
Practice Address - Phone:970-663-1962
Practice Address - Fax:970-776-5596
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6199183500000X
CO20340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20340OtherSTATE LICENSE NUMBER
SD6199OtherSTATE LICENSE NUMBER