Provider Demographics
NPI:1174117501
Name:CUMMINGS, REGINALD (RPH, MBA)
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 N MYRTLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3041
Mailing Address - Country:US
Mailing Address - Phone:267-981-7999
Mailing Address - Fax:
Practice Address - Street 1:1091 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9157
Practice Address - Country:US
Practice Address - Phone:610-530-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044374L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist