Provider Demographics
NPI:1487257564
Name:GRABLE, REBECCA MARIE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:GRABLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 SPUR DR
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-2350
Mailing Address - Country:US
Mailing Address - Phone:417-859-5394
Mailing Address - Fax:
Practice Address - Street 1:1260 SPUR DR
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MO
Practice Address - Zip Code:65706-2350
Practice Address - Country:US
Practice Address - Phone:417-859-5394
Practice Address - Fax:417-859-5401
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016042852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist