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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