Provider Demographics
NPI:1750435640
Name:REIER, LAURA JEAN (RPH)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JEAN
Last Name:REIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CAPTAINS WAY
Mailing Address - Street 2:
Mailing Address - City:REEDVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22539-3221
Mailing Address - Country:US
Mailing Address - Phone:804-453-4494
Mailing Address - Fax:
Practice Address - Street 1:132 CAPTAINS WAY
Practice Address - Street 2:
Practice Address - City:REEDVILLE
Practice Address - State:VA
Practice Address - Zip Code:22539-3221
Practice Address - Country:US
Practice Address - Phone:804-435-6473
Practice Address - Fax:804-435-8667
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13559183500000X
VA0202206897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist