Provider Demographics
NPI:1255920864
Name:RATAJCZAK, WHITNEY ROSE (PHARMD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ROSE
Last Name:RATAJCZAK
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 1:167 MARGUERITE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4679
Mailing Address - Country:US
Mailing Address - Phone:502-751-9563
Mailing Address - Fax:
Practice Address - Street 1:167 MARGUERITE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4679
Practice Address - Country:US
Practice Address - Phone:502-751-9563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist