Provider Demographics
NPI:1750653317
Name:REHA, CRAIG (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:REHA
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988121 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8121
Mailing Address - Country:US
Mailing Address - Phone:402-552-2293
Mailing Address - Fax:
Practice Address - Street 1:2605 S 171ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2389
Practice Address - Country:US
Practice Address - Phone:402-697-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-29
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist