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NPI Code Detail

MEDICARE: DR. DEBRA JEAN REID PHARM.D.

MEDICARE: DR. DEBRA JEAN REID PHARM.D.
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
1183500000XPharmacist26306MA

General Provider Information

NPI Number : 1104813856
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA JEAN REID PHARM.D.
Provider Business Mailing Address
First Line : 55 DIMOCK ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1029
Country : US
Telephone Number : 617-442-8800
Fax Number :
Provider Business Practice Location Address
First Line : 45 DIMOCK ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1208
Country : US
Telephone Number : 617-442-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 04/09/2020

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