Provider Demographics
NPI:1366087249
Name:REINEKE, MONICA R (PHARMD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:R
Last Name:REINEKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 ROBINS WAY APT 2B
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-8863
Mailing Address - Country:US
Mailing Address - Phone:808-740-3915
Mailing Address - Fax:
Practice Address - Street 1:325 ROBINS WAY APT 2B
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-8863
Practice Address - Country:US
Practice Address - Phone:808-740-3915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4092183500000X
PA454088183500000X
MD18331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist