Provider Demographics
NPI:1699379818
Name:RIFFE, GABRIELLE C (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:C
Last Name:RIFFE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HANSEL AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4869
Mailing Address - Country:US
Mailing Address - Phone:859-371-2245
Mailing Address - Fax:
Practice Address - Street 1:1100 HANSEL AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4869
Practice Address - Country:US
Practice Address - Phone:859-371-2245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH034390891835P0018X
KY0209191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY020919OtherSTATE LICENSE NUMBER
OH03439089OtherSTATE LICENSE NUMBER