Provider Demographics
NPI:1053698001
Name:BROWN, REBECCA DELL (PHARMD)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:DELL
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:BROWN
Other - Last Name:PENNINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15412 PATRICK HENRY HWY
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002
Mailing Address - Country:US
Mailing Address - Phone:804-561-6885
Mailing Address - Fax:804-561-6897
Practice Address - Street 1:11290 W BROAD ST
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5815
Practice Address - Country:US
Practice Address - Phone:804-360-8912
Practice Address - Fax:804-360-8912
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist