Provider Demographics
NPI:1114184116
Name:REED, STEVEN DUANE (RPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DUANE
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 1:3620 SW TROUT ST
Mailing Address - Street 2:PO BOX 1783
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34431-3571
Mailing Address - Country:US
Mailing Address - Phone:352-489-9778
Mailing Address - Fax:352-489-4012
Practice Address - Street 1:3620 SW TROUT ST
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34431-3571
Practice Address - Country:US
Practice Address - Phone:352-489-9778
Practice Address - Fax:352-489-4012
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26-1582275Medicare UPIN