Provider Demographics
NPI:1093585614
Name:REED, PATRICK SR
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:REED
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-2263
Mailing Address - Country:US
Mailing Address - Phone:870-573-7352
Mailing Address - Fax:870-206-7955
Practice Address - Street 1:806 MELODY LN
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2263
Practice Address - Country:US
Practice Address - Phone:870-573-7352
Practice Address - Fax:870-206-7955
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)