Healthcare Provider Details

I. General information

NPI: 1508895863
Provider Name (Legal Business Name): REID HOSPITAL & HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 REID PKWY
RICHMOND IN
47374-1157
US

IV. Provider business mailing address

1100 REID PKWY MEDICAL STAFF SERVICES
RICHMOND IN
47374-1157
US

V. Phone/Fax

Practice location:
  • Phone: 765-983-3307
  • Fax:
Mailing address:
  • Phone: 765-983-3014
  • Fax: 765-983-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number05-005044-1
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number05-005044-1
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number05-005044-1
License Number StateIN

VIII. Authorized Official

Name: MR. CRAIG KINYON
Title or Position: PRESIDENT - REID HOSPITAL
Credential:
Phone: 765-983-3122