MEDICARE: MR. JOHN W REED JR. R. PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	007852	KY
2	183500000X	Pharmacist	26016533A	IN

General Provider Information

NPI Number	:	1043507098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN W REED JR. R. PH.

Provider Business Mailing Address
First Line	:	7311 JEFFERSON BLVD
Second Line	:	T-1513
City	:	LOUISVILLE
State	:	KY
Zip	:	40219-6178
Country	:	US
Telephone Number	:	502-968-9256
Fax Number	:	502-968-9256

Provider Business Practice Location Address
First Line	:	7311 JEFFERSON BLVD
Second Line	:	T-1513
City	:	LOUISVILLE
State	:	KY
Zip	:	40219-6178
Country	:	US
Telephone Number	:	502-968-9256
Fax Number	:	502-968-9256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2011
Last Update Date	:	06/28/2011

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