Organization
REYNOLDS PHARMACY INC
Active
Other names
Doctors Custom Compounding
Organization subpart
No
Provider details
NPI number
Authorized official
DAN REYNOLDS (PRESIDENT OWNER)
(262) 473-3444
Entity
Organization
Contact information
Practice address
162 W MAIN ST STE K, WHITEWATER, WI 53190-1995
(262) 473-3444
(262) 473-3444
Mailing address
162 W MAIN ST, STE K, WHITEWATER, WI 53190-1995
(262) 473-3444
(262) 473-3444
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9277-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114604
PK
—
05
—
33061500
—
WI
Enumeration date
07/30/2006
Last updated
10/29/2014
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