Provider Demographics
NPI:1477155190
Name:TURNER, JEREMY DEWAYNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:DEWAYNE
Last Name:TURNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 WOODBINE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2935
Mailing Address - Country:US
Mailing Address - Phone:757-748-8626
Mailing Address - Fax:
Practice Address - Street 1:1900 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4260
Practice Address - Country:US
Practice Address - Phone:757-826-7142
Practice Address - Fax:757-827-1481
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202205886OtherPHARMACY BOARD OF VIRGINIA