Provider Demographics
NPI:1659975324
Name:REINHARDT, DEANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4737 VALLEY VIEW BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-2000
Mailing Address - Country:US
Mailing Address - Phone:540-362-7955
Mailing Address - Fax:
Practice Address - Street 1:4737 VALLEY VIEW BLVD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-2000
Practice Address - Country:US
Practice Address - Phone:540-362-7955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist