Provider Demographics
NPI:1871826503
Name:RAINESS, EILEEN MARY (RPH)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:MARY
Last Name:RAINESS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 POPLAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8151
Mailing Address - Country:US
Mailing Address - Phone:704-799-9223
Mailing Address - Fax:
Practice Address - Street 1:230 E PLAZA DR
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-8097
Practice Address - Country:US
Practice Address - Phone:704-662-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist