MEDICARE: LISA REILLY RPH

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	RP039777R	PA

General Provider Information

NPI Number	:	1760143978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA REILLY RPH

Provider Business Mailing Address
First Line	:	256 BROOKWOOD DR S
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-4904
Country	:	US
Telephone Number	:	717-332-0785
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 N CHARLOTTE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3702
Country	:	US
Telephone Number	:	717-984-2204
Fax Number	:

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

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/10/2022

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