Provider Demographics
NPI:1447721030
Name:HOWARD, RACHEL QUINN (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:QUINN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 LEAFWOOD LN APT 184
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-6249
Mailing Address - Country:US
Mailing Address - Phone:309-706-8524
Mailing Address - Fax:
Practice Address - Street 1:25 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2834
Practice Address - Country:US
Practice Address - Phone:860-536-5635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist