Provider Demographics
NPI:1164516647
Name:REICH'S PHARMACY, INC
Entity Type:Organization
Organization Name:REICH'S PHARMACY, INC
Other - Org Name:HAROLD K REICH'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER/RPH
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:209-835-1832
Mailing Address - Street 1:39 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3901
Mailing Address - Country:US
Mailing Address - Phone:209-835-1832
Mailing Address - Fax:209-835-0704
Practice Address - Street 1:39 W 10TH ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3901
Practice Address - Country:US
Practice Address - Phone:209-835-1832
Practice Address - Fax:209-835-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY45237333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA452370Medicaid
CAPHA452370Medicaid