Reynolds Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9277-42 Issued in WI

Legal business name

REYNOLDS PHARMACY INC

Practice address

162 W Main St Ste K
Whitewater, WI 53190-1995

Phone

(262) 473-3444

Fax

(262) 473-3444

NPI assigned

Jul 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dan Reynolds

Title

President Owner

Phone

(262) 473-3444

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Doctors Custom Compounding Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1922013564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 W MAIN ST",
            "address_2": "STE K",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901995",
            "telephone_number": "262-473-3444",
            "fax_number": "262-473-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W MAIN ST STE K",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901995",
            "telephone_number": "262-473-3444",
            "fax_number": "262-473-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "262-473-3444"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9277-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2114604",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33061500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Custom Compounding",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyssa Michele Pautsch, DPT
• Erin Leeann Pechous, LPN
• Charles Penn
• Alexander Pham
• Sarah Ann Pope, DO
• Katie Laura Reynolds-Oezer, LPN
• Danny Ray Reynolds, RPH
• Rock River Community Clinic Inc
• Rock River Foot & Ankle Clinic, SC
• Cheryl L. Roux, APRN, FNP

• Community/Retail Pharmacy in Whitewater, WI
• Providers in Whitewater, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.