Provider Demographics
NPI:1346329448
Name:RIFFERT, CHRISTIAN VINCENT (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:VINCENT
Last Name:RIFFERT
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 E HURLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-9727
Mailing Address - Country:US
Mailing Address - Phone:989-839-0239
Mailing Address - Fax:
Practice Address - Street 1:127 W BROWN ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612-8119
Practice Address - Country:US
Practice Address - Phone:989-435-7778
Practice Address - Fax:989-435-2581
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist