Provider Demographics
NPI:1013274554
Name:REED, JOHN P (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
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 1:58 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:ERIAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2310
Mailing Address - Country:US
Mailing Address - Phone:856-566-7451
Mailing Address - Fax:
Practice Address - Street 1:1163 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5001
Practice Address - Country:US
Practice Address - Phone:856-205-7371
Practice Address - Fax:856-205-7377
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02277300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist