Provider Demographics
NPI:1922397389
Name:OOMMEN, REETHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:REETHA
Middle Name:
Last Name:OOMMEN
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 1:2108 MACARTHUR RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-4520
Mailing Address - Country:US
Mailing Address - Phone:610-740-9401
Mailing Address - Fax:610-740-9406
Practice Address - Street 1:5600 N 23RD ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3959
Practice Address - Country:US
Practice Address - Phone:956-683-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist