Provider Demographics
NPI:1114001781
Name:RIFFERT, ROBERT (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:RIFFERT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 575
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:MI
Mailing Address - Zip Code:48612-0575
Mailing Address - Country:US
Mailing Address - Phone:989-435-7778
Mailing Address - Fax:989-435-2581
Practice Address - Street 1:127 W BROWN ST
Practice Address - Street 2:PO 575
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612-8119
Practice Address - Country:US
Practice Address - Phone:989-435-7778
Practice Address - Fax:989-435-2581
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2351485OtherNCPDP
MI1497844047OtherNPI
MI540B603020OtherBCBS MICHIGAN DME
MI2933529Medicaid
MI2933538Medicaid
MI1497844047OtherNPI