Healthcare Provider Details

I. General information

NPI: 1437261716
Provider Name (Legal Business Name): SHAWN M. REED RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 MARIE DR
LITITZ PA
17543-7923
US

IV. Provider business mailing address

17 MARIE DR
LITITZ PA
17543-7923
US

V. Phone/Fax

Practice location:
  • Phone: 717-625-0077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP040811L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierRP040811L
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPHARMACIST LICENSE #

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: