Healthcare Provider Details
I. General information
NPI: 1770502775
Provider Name (Legal Business Name): DAVID A RHEIN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1481 W 10TH ST
INDIANAPOLIS IN
46202-2803
US
IV. Provider business mailing address
1481 W 10TH ST
INDIANAPOLIS IN
46202-2803
US
V. Phone/Fax
- Phone: 317-554-0000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | 26019382A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: