Provider Demographics
NPI:1427347046
Name:RIEGEL, WARREN F (RPH)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:F
Last Name:RIEGEL
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 1:3784 LINK DR
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1822
Mailing Address - Country:US
Mailing Address - Phone:610-350-7866
Mailing Address - Fax:
Practice Address - Street 1:636 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-1632
Practice Address - Country:US
Practice Address - Phone:302-994-3473
Practice Address - Fax:302-994-0171
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001610183500000X
PARP028163L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist