Provider Demographics
NPI:1699320093
Name:REYES, MARILOU ARIAS (RPH)
Entity type:Individual
Prefix:
First Name:MARILOU
Middle Name:ARIAS
Last Name:REYES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4304
Mailing Address - Country:US
Mailing Address - Phone:775-329-2981
Mailing Address - Fax:775-786-4893
Practice Address - Street 1:525 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4304
Practice Address - Country:US
Practice Address - Phone:775-329-2981
Practice Address - Fax:775-786-4893
Is Sole Proprietor?:No
Enumeration Date:2019-08-03
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist