Provider Demographics
NPI:1467586495
Name:BONHAM, REED (RPH)
Entity Type:Individual
Prefix:MR
First Name:REED
Middle Name:
Last Name:BONHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4077 W CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6883
Mailing Address - Country:US
Mailing Address - Phone:559-271-3177
Mailing Address - Fax:559-271-3182
Practice Address - Street 1:4077 W CLINTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6883
Practice Address - Country:US
Practice Address - Phone:559-271-3177
Practice Address - Fax:559-271-3182
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist