Provider Demographics
NPI:1053939413
Name:REAMS, BLAINE THOMAS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BLAINE
Middle Name:THOMAS
Last Name:REAMS
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 1:94 ROWSE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4062
Mailing Address - Country:US
Mailing Address - Phone:540-915-2873
Mailing Address - Fax:
Practice Address - Street 1:4119 BOONSBORO RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2340
Practice Address - Country:US
Practice Address - Phone:434-384-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218761183500000X
AL21399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist