MEDICARE: MR. RAYMOND HENRY RESER JR. 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	03-3-20207	OH

General Provider Information

NPI Number	:	1801889241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAYMOND HENRY RESER JR. RPH

Provider Business Mailing Address
First Line	:	701 HOSPITAL LOOP
Second Line	:	ATTN: PHARMACY
City	:	FAIRCHILD AFB
State	:	WA
Zip	:	99011-8704
Country	:	US
Telephone Number	:	509-247-4370
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 HOSPITAL LOOP
Second Line	:	ATTN: PHARMACY
City	:	FAIRCHILD AFB
State	:	WA
Zip	:	99011-8704
Country	:	US
Telephone Number	:	509-247-4370
Fax Number	:

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	07/08/2007

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