Healthcare Provider Details

I. General information

NPI: 1790992873
Provider Name (Legal Business Name): WILLIAM R. REEVES RPH, PHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BILL REEVES RPH, PHC

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SAINT MICHAELS DR ST. VINCENT HOSPITAL, ANTICOAGULATION MANAGEMENT SERVIC
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

465 SAINT MICHAELS DR SUITE 110
SANTA FE NM
87505-7670
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-5287
  • Fax: 505-913-4949
Mailing address:
  • Phone: 505-913-5287
  • Fax: 505-913-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number00000066
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: