Provider Demographics
NPI:1942563630
Name:REITZ, RICHARD WILLIAM (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:REITZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5723 BEACH HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:EAST NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21631-1639
Mailing Address - Country:US
Mailing Address - Phone:410-428-3010
Mailing Address - Fax:
Practice Address - Street 1:200 KENT LNDG
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2582
Practice Address - Country:US
Practice Address - Phone:410-643-9604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist