Provider Demographics
NPI:1962999300
Name:REIF, DANIEL A (RPH)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:REIF
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 1:6523 PARALLEL PKWY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1044
Mailing Address - Country:US
Mailing Address - Phone:913-788-3344
Mailing Address - Fax:913-788-8705
Practice Address - Street 1:6523 PARALLEL PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1044
Practice Address - Country:US
Practice Address - Phone:913-788-3344
Practice Address - Fax:913-788-8705
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200616390AMedicaid