Healthcare Provider Details

I. General information

NPI: 1750435640
Provider Name (Legal Business Name): LAURA JEAN REIER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 CAPTAINS WAY
REEDVILLE VA
22539-3221
US

IV. Provider business mailing address

132 CAPTAINS WAY
REEDVILLE VA
22539-3221
US

V. Phone/Fax

Practice location:
  • Phone: 804-435-6473
  • Fax: 804-435-8667
Mailing address:
  • Phone: 804-453-4494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13559
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202206897
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: