Organization
GALAHADD'S QUEST LLC
Active
Organization
GALAHADD'S QUEST LLC
Active
Other names
Reichardt Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY ALAN REICHARDT CNP (OWNER)
(419) 331-2273
Entity
Organization
Contact information
Practice address
2440 BATON ROUGE, LIMA, OH 45805-5104
(419) 331-2273
(419) 331-4274
Mailing address
2440 BATON ROUGE, SUITE 306, LIMA, OH 45805-5104
(419) 331-2273
(419) 331-4274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA10079-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51149
BCBS-OH
OH
05
—
0B51149
—
OH
01
—
6268010001
MEDICARE DME
—
01
—
A503JREICHART:80561
PERSE ESN
—
01
—
H006310
MEDICARE PTAN
—
Enumeration date
04/19/2011
Last updated
08/24/2011
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