Healthcare Provider Details

I. General information

NPI: 1164516647
Provider Name (Legal Business Name): REICH'S PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 W 10TH ST
TRACY CA
95376-3901
US

IV. Provider business mailing address

39 W 10TH ST
TRACY CA
95376-3901
US

V. Phone/Fax

Practice location:
  • Phone: 209-835-1832
  • Fax: 209-835-0704
Mailing address:
  • Phone: 209-835-1832
  • Fax: 209-835-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY45237
License Number StateCA

VIII. Authorized Official

Name: DR. HAROLD KEITH REICH
Title or Position: GENERAL PARTNER/RPH
Credential: PHARM D
Phone: 209-835-1832