MEDICARE: RHIANNON REYNOLDS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	071891	NY

General Provider Information

NPI Number	:	1366385593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHIANNON REYNOLDS PHARMD

Provider Business Mailing Address
First Line	:	1308 WASHINGTON ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-4532
Country	:	US
Telephone Number	:	315-836-2017
Fax Number	:	315-998-8121

Provider Business Practice Location Address
First Line	:	1308 WASHINGTON ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-4532
Country	:	US
Telephone Number	:	315-836-2017
Fax Number	:	315-998-8121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ RHIANNON REYNOLDS PHARMD” Practice Location

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