Provider Demographics
NPI:1447503529
Name:2RKS
Entity type:Organization
Organization Name:2RKS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAINES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:828-678-3914
Mailing Address - Street 1:PO BOX 1420
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-1420
Mailing Address - Country:US
Mailing Address - Phone:828-678-3914
Mailing Address - Fax:828-678-3945
Practice Address - Street 1:730 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-3102
Practice Address - Country:US
Practice Address - Phone:828-678-3914
Practice Address - Fax:828-678-3945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty