Provider Demographics
NPI:1295511723
Name:REYNOLDS, STEVEN ALEXANDER (PHARMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALEXANDER
Last Name:REYNOLDS
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 1:3166 TOLER CRK
Mailing Address - Street 2:
Mailing Address - City:HAROLD
Mailing Address - State:KY
Mailing Address - Zip Code:41635-8812
Mailing Address - Country:US
Mailing Address - Phone:606-594-5008
Mailing Address - Fax:
Practice Address - Street 1:3404 CAMARGO RD
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-8864
Practice Address - Country:US
Practice Address - Phone:859-497-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist