Provider Demographics
NPI:1780358507
Name:REIFF, OLGA (PHARMD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:REIFF
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 1:9849 FRONTENAC DR
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49346-9671
Mailing Address - Country:US
Mailing Address - Phone:269-816-0884
Mailing Address - Fax:
Practice Address - Street 1:1306 S MISSION ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-4208
Practice Address - Country:US
Practice Address - Phone:989-772-1945
Practice Address - Fax:989-772-1946
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5302415294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program