Provider Demographics
NPI:1568747681
Name:REED, LORIE A (RPH)
Entity Type:Individual
Prefix:
First Name:LORIE
Middle Name:A
Last Name:REED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9331 NEWTON AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-2909
Mailing Address - Country:US
Mailing Address - Phone:612-339-0363
Mailing Address - Fax:612-339-6935
Practice Address - Street 1:815 NICOLLET MALL
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2504
Practice Address - Country:US
Practice Address - Phone:612-339-0363
Practice Address - Fax:612-339-6935
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist