Provider Demographics
NPI:1902106412
Name:THARIO, REBECCA (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:THARIO
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 1:6706 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2362
Mailing Address - Country:US
Mailing Address - Phone:907-250-6368
Mailing Address - Fax:
Practice Address - Street 1:6706 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2362
Practice Address - Country:US
Practice Address - Phone:907-250-6368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-31
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist