Provider Demographics
NPI:1427170695
Name:REEVES, GARY ALAN (RPH)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:ALAN
Last Name:REEVES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4000
Mailing Address - Street 2:HOPI HEALTH CARE CENTER
Mailing Address - City:POLACCA
Mailing Address - State:AZ
Mailing Address - Zip Code:86042-4000
Mailing Address - Country:US
Mailing Address - Phone:928-737-6190
Mailing Address - Fax:928-737-6332
Practice Address - Street 1:HIGHWAY 264 MILE MARKER 388
Practice Address - Street 2:HOPI HEALTH CARE CENTER
Practice Address - City:POLACCA
Practice Address - State:AZ
Practice Address - Zip Code:86042
Practice Address - Country:US
Practice Address - Phone:928-737-6190
Practice Address - Fax:928-737-6332
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist