1396827044 NPI number — DR. REBECCA ELLEN REYES PHARM.D.

Table of content: DR. REBECCA ELLEN REYES PHARM.D. (NPI 1396827044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396827044 NPI number — DR. REBECCA ELLEN REYES PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REYES
Provider First Name:
REBECCA
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARNER/WHITAKER
Provider Other First Name:
REBECCA
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396827044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
C/O MANIIAG HEALTH CENTER - PHARMACY DEPT.
Provider Second Line Business Mailing Address:
436 5TH AVE
Provider Business Mailing Address City Name:
KOTZEBUE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-573-2254
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
C/O MANIIAG HEALTH CENTER - PHARMACY DEPT.
Provider Second Line Business Practice Location Address:
436 5TH AVE
Provider Business Practice Location Address City Name:
KOTZEBUE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-573-2254
Provider Business Practice Location Address Fax Number:
602-263-1621
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  S12266 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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