Provider Demographics
NPI:1164789178
Name:RIEDER, REBECCA A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:A
Last Name:RIEDER
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 1:5988 BETHANY RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9247
Mailing Address - Country:US
Mailing Address - Phone:513-398-1559
Mailing Address - Fax:
Practice Address - Street 1:5988 BETHANY RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9247
Practice Address - Country:US
Practice Address - Phone:513-398-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-15
Last Update Date:2012-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033183811835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology