Provider Demographics
NPI:1053563312
Name:DELLIOR, REBA V (RPH)
Entity type:Individual
Prefix:
First Name:REBA
Middle Name:V
Last Name:DELLIOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 S 70TH ST
Mailing Address - Street 2:BLUE BELL SHOPPING CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2502
Mailing Address - Country:US
Mailing Address - Phone:215-365-3400
Mailing Address - Fax:
Practice Address - Street 1:2910 S 70TH ST
Practice Address - Street 2:BLUE BELL SHOPPING CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2502
Practice Address - Country:US
Practice Address - Phone:215-365-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045119L183500000X
DEA1-0003132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist