Provider Demographics
NPI:1285808006
Name:REAMES, RANDY COOK (RPH)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:COOK
Last Name:REAMES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HIGHWAY 17 N
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-6031
Mailing Address - Country:US
Mailing Address - Phone:843-238-9292
Mailing Address - Fax:843-477-0300
Practice Address - Street 1:320 HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-6031
Practice Address - Country:US
Practice Address - Phone:843-238-9292
Practice Address - Fax:843-477-0300
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC005629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist