Provider Demographics
NPI:1437299070
Name:REID HOSPITAL & HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:REID HOSPITAL & HEALTH CARE SERVICES
Other - Org Name:REID HOSPITAL & HEALTH CARE SVCS PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT - REID HOSPITAL
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KINYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-983-3123
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-962-6053
Mailing Address - Fax:
Practice Address - Street 1:1100 REID PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1157
Practice Address - Country:US
Practice Address - Phone:765-962-6053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-005044-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100269710AMedicaid
OH7262751Medicaid
INCE1747Medicare Oscar/Certification
OH7262751Medicaid
IN940940Medicare ID - Type UnspecifiedREID HOSPITAL PHYSICIANS