Provider Demographics
NPI:1427103704
Name:CALVERT, RACHEL LYNNETTE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LYNNETTE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LYNNETTE
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2550 LAKE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-4220
Mailing Address - Country:US
Mailing Address - Phone:317-879-2465
Mailing Address - Fax:317-879-2466
Practice Address - Street 1:2550 LAKE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4220
Practice Address - Country:US
Practice Address - Phone:317-879-2465
Practice Address - Fax:317-879-2466
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022151A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26022151AOtherLICENSE NUMBER