Provider Demographics
NPI:1396210688
Name:WALDRON, REESHA BRODEUR (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:REESHA
Middle Name:BRODEUR
Last Name:WALDRON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:169 BEAUCHAMP TER
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4101
Mailing Address - Country:US
Mailing Address - Phone:413-297-6157
Mailing Address - Fax:413-543-0042
Practice Address - Street 1:1600 BOSTON RD
Practice Address - Street 2:PHARMACY DEPT - REESHA WALDRON FLOATER RPH
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01129
Practice Address - Country:US
Practice Address - Phone:413-543-5428
Practice Address - Fax:413-543-0042
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist