Provider Demographics
NPI:1467719823
Name:RHEAULT, CINDY LOU (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LOU
Last Name:RHEAULT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 1ST ST PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:WANBLEE
Mailing Address - State:SD
Mailing Address - Zip Code:57577-0290
Mailing Address - Country:US
Mailing Address - Phone:605-462-6155
Mailing Address - Fax:605-462-6631
Practice Address - Street 1:210 1ST ST
Practice Address - Street 2:
Practice Address - City:WANBLEE
Practice Address - State:SD
Practice Address - Zip Code:57577-0290
Practice Address - Country:US
Practice Address - Phone:605-462-6155
Practice Address - Fax:605-462-6631
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist