Provider Demographics
NPI:1417622762
Name:REIDT PHARMACY CORPERATION
Entity Type:Organization
Organization Name:REIDT PHARMACY CORPERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:REIDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:509-624-2111
Mailing Address - Street 1:601 W RIVERSIDE AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0622
Mailing Address - Country:US
Mailing Address - Phone:509-624-2111
Mailing Address - Fax:509-624-9500
Practice Address - Street 1:601 W RIVERSIDE AVE STE 140B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0621
Practice Address - Country:US
Practice Address - Phone:509-624-2111
Practice Address - Fax:509-624-9500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REIDT PHARMACY CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-10
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy