=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134618762
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REED'S HEALTH ADVANTAGE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2018
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 430 N WOLF CREEK ST
-----------------------------------------------------
City | BROOKVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45309-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-770-4381
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 430 N WOLF CREEK ST
-----------------------------------------------------
City | BROOKVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45309-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-770-4381
-----------------------------------------------------
Fax | 937-770-4383
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | GARY REED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-687-6081
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 02288155003
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------