Provider Demographics
NPI:1497038947
Name:O'REILLY, REBECCA REA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:REA
Last Name:O'REILLY
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 1:536 CORISANDE HILLS RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-5613
Mailing Address - Country:US
Mailing Address - Phone:636-343-5699
Mailing Address - Fax:
Practice Address - Street 1:4535 HUNTER LN
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051
Practice Address - Country:US
Practice Address - Phone:636-375-3656
Practice Address - Fax:636-375-3647
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1835P1200X1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy