Provider Demographics
NPI:1679003610
Name:REICHARD, DANA BENDALL (PHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:BENDALL
Last Name:REICHARD
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5647 LAKE TRACE DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3969
Mailing Address - Country:US
Mailing Address - Phone:205-585-3154
Mailing Address - Fax:
Practice Address - Street 1:2780 JOHN HAWKINS PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4001
Practice Address - Country:US
Practice Address - Phone:205-733-0055
Practice Address - Fax:205-733-0246
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist