Healthcare Provider Details

I. General information

NPI: 1437188786
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: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 REID PARKWAY
RICHMOND IN
47374-1157
US

IV. Provider business mailing address

1100 REID PARKWAY
RICHMOND IN
47374-1157
US

V. Phone/Fax

Practice location:
  • Phone: 765-983-3000
  • Fax:
Mailing address:
  • Phone: 765-983-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number05-005044-1
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number11-005044-1
License Number StateIN

VIII. Authorized Official

Name: MR. CRAIG C. KINYON
Title or Position: PRESIDENT / CEO
Credential:
Phone: 765-983-3122