Provider Demographics
NPI:1750502258
Name:REAMES, JASON ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ROBERT
Last Name:REAMES
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 1:23800 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-3152
Mailing Address - Country:US
Mailing Address - Phone:952-401-3990
Mailing Address - Fax:952-401-3881
Practice Address - Street 1:23800 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-3152
Practice Address - Country:US
Practice Address - Phone:952-401-3990
Practice Address - Fax:952-401-3881
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4882183500000X
MN117537-4183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist