Provider Demographics
NPI:1396028536
Name:REINKE, COLLIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:
Last Name:REINKE
Suffix:
Gender:M
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 1:3333 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6565
Mailing Address - Country:US
Mailing Address - Phone:406-652-1620
Mailing Address - Fax:406-652-4620
Practice Address - Street 1:3333 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6565
Practice Address - Country:US
Practice Address - Phone:406-652-1620
Practice Address - Fax:406-652-4620
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist