Provider Demographics
NPI:1467122820
Name:REIS, RACHEL DAWN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DAWN
Last Name:REIS
Suffix:
Gender:F
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 1:950 COUNTY ROAD 42 W
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4428
Mailing Address - Country:US
Mailing Address - Phone:952-892-7777
Mailing Address - Fax:
Practice Address - Street 1:950 COUNTY ROAD 42 W
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4428
Practice Address - Country:US
Practice Address - Phone:952-892-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist