Healthcare Provider Details

I. General information

NPI: 1437940822
Provider Name (Legal Business Name): MIREMBE REED
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST
BRIGHTON MA
02135-2907
US

IV. Provider business mailing address

1148 HIGHLAND ST
HOLLISTON MA
01746-1602
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-2450
  • Fax:
Mailing address:
  • Phone: 508-903-3449
  • Fax: 508-903-3449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPH25747
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1835C0206X
TaxonomyCardiology Pharmacist
License NumberPH25747
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: