Healthcare Provider Details

I. General information

NPI: 1366470098
Provider Name (Legal Business Name): ANDREW JAMES REEVES R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OAKLAND DR
KALAMAZOO MI
49008-1282
US

IV. Provider business mailing address

8589 SIERRA MADRE TRL
KALAMAZOO MI
49009-6908
US

V. Phone/Fax

Practice location:
  • Phone: 269-337-6330
  • Fax: 269-337-6366
Mailing address:
  • Phone: 269-217-1672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302028169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: