Organization
REISZ PHARMACEUTICALS VITAL CARE, INC.
Active
Other names
Reisz Pharmaceuticals Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
E REISZ (OWNER)
(270) 683-7379
Entity
Organization
Contact information
Practice address
2315 MAYFAIR DR, MAYFAIR SQUARE PROFESSIONAL BUILDING, OWENSBORO, KY 42301-4557
(270) 683-7379
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
P02023
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000069966
BCBS
KY
01
—
1445572
UMWA
—
01
—
4055675
BCBS, NON-PAR
TN
05
—
54029384
—
KY
01
—
61128006
CHAMPUS/TRICARE
—
05
—
90140302
—
KY
Enumeration date
08/16/2006
Last updated
08/22/2020
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