Provider Demographics
NPI:1063462455
Name:REED, KEVIN B (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:B
Last Name:REED
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 1:2489 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-6078
Mailing Address - Country:US
Mailing Address - Phone:570-390-7655
Mailing Address - Fax:570-390-7657
Practice Address - Street 1:2489 ROUTE 6
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-6078
Practice Address - Country:US
Practice Address - Phone:570-390-7655
Practice Address - Fax:570-390-7657
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-039894-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP-039894-LOtherPHARMACIST LICENSE