Healthcare Provider Details

I. General information

NPI: 1134307036
Provider Name (Legal Business Name): RPSM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5078 WILLIAMSPORT PIKE STE A
MARTINSBURG WV
25404-6458
US

IV. Provider business mailing address

5078 WILLIAMSPORT PIKE STE A
MARTINSBURG WV
25404-6458
US

V. Phone/Fax

Practice location:
  • Phone: 304-267-6655
  • Fax: 304-267-6966
Mailing address:
  • Phone: 304-267-6655
  • Fax: 304-267-6966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberSP0552371
License Number StateWV

VIII. Authorized Official

Name: KENNETH REED
Title or Position: OWNER
Credential: BS
Phone: 304-258-3800