Provider Demographics
NPI:1376278093
Name:REINHART, MACKENZIE FAITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:FAITH
Last Name:REINHART
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 1:30 CAMPDEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6537
Mailing Address - Country:US
Mailing Address - Phone:870-278-3642
Mailing Address - Fax:
Practice Address - Street 1:5200 KAVANAUGH BLVD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4609
Practice Address - Country:US
Practice Address - Phone:501-664-3844
Practice Address - Fax:501-664-3744
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD16212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist