Provider Demographics
NPI:1912329509
Name:RIEDER, GENE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:
Last Name:RIEDER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 WHITE POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33876-5701
Mailing Address - Country:US
Mailing Address - Phone:239-218-2625
Mailing Address - Fax:
Practice Address - Street 1:208 WHITE POPLAR ST
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33876-5701
Practice Address - Country:US
Practice Address - Phone:239-218-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS232671835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist