Provider Demographics
NPI:1598709958
Name:HAIN, REGINALD LEE (RP)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:LEE
Last Name:HAIN
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 26TH ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-9740
Mailing Address - Country:US
Mailing Address - Phone:308-946-5149
Mailing Address - Fax:
Practice Address - Street 1:1715 26TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-9501
Practice Address - Country:US
Practice Address - Phone:308-946-5981
Practice Address - Fax:308-946-5911
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist