Provider Demographics
NPI:1134307036
Name:RPSM LLC
Entity Type:Organization
Organization Name:RPSM LLC
Other - Org Name:REEDS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:304-258-3800
Mailing Address - Street 1:5078 WILLIAMSPORT PIKE
Mailing Address - Street 2:STE A
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-6458
Mailing Address - Country:US
Mailing Address - Phone:304-267-6655
Mailing Address - Fax:304-267-6966
Practice Address - Street 1:5078 WILLIAMSPORT PIKE
Practice Address - Street 2:STE A
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-6458
Practice Address - Country:US
Practice Address - Phone:304-267-6655
Practice Address - Fax:304-267-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
WVSP05523713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2111732OtherPK
5054692OtherNCPDP PROVIDER IDENTIFICATION NUMBER