Provider Demographics
NPI:1265554273
Name:REEVES, TAMARA DENEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:DENEE
Last Name:REEVES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 FRANKLIN DALE CV
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3890
Mailing Address - Country:US
Mailing Address - Phone:901-853-5123
Mailing Address - Fax:
Practice Address - Street 1:275 NEW BYHALIA RD
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3904
Practice Address - Country:US
Practice Address - Phone:901-861-9534
Practice Address - Fax:901-861-4160
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist