Provider Demographics
NPI:1568889780
Name:REICHERT, JOSEPH (RPH, BCPP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:REICHERT
Suffix:
Gender:M
Credentials:RPH, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28178 SCHRIBER ST
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-9720
Mailing Address - Country:US
Mailing Address - Phone:419-381-1881
Mailing Address - Fax:
Practice Address - Street 1:930 S DETROIT AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2701
Practice Address - Country:US
Practice Address - Phone:419-381-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-220031835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric