Provider Demographics
NPI:1700480928
Name:PACHECO, RAQUEL ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:ANN
Last Name:PACHECO
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 1:1620 PRESIDENT AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-7148
Mailing Address - Country:US
Mailing Address - Phone:508-672-2403
Mailing Address - Fax:508-672-8928
Practice Address - Street 1:1620 PRESIDENT AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-7148
Practice Address - Country:US
Practice Address - Phone:508-672-2403
Practice Address - Fax:508-672-8928
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty