Healthcare Provider Details

I. General information

NPI: 1457363558
Provider Name (Legal Business Name): MARY B. RIEGLE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 GEORGESVILLE RD
COLUMBUS OH
43228-2420
US

IV. Provider business mailing address

4600 ARROWHEAD RD
POWELL OH
43065-8949
US

V. Phone/Fax

Practice location:
  • Phone: 614-279-9368
  • Fax: 614-792-0483
Mailing address:
  • Phone: 614-792-3368
  • Fax: 614-792-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-13499
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: