Provider Demographics
NPI:1164635678
Name:REED, PAMELA LEE
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LEE
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 BRYSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2013
Mailing Address - Country:US
Mailing Address - Phone:614-447-1216
Mailing Address - Fax:
Practice Address - Street 1:3426 EISENHOUR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2013
Practice Address - Country:US
Practice Address - Phone:614-262-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2424371Medicaid