MEDICARE: KENNETH R REED 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	RP0005242	WV

General Provider Information

NPI Number	:	1326045576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH R REED R.PH.

Provider Business Mailing Address
First Line	:	4253 MARTINSBURG RD
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-5059
Country	:	US
Telephone Number	:	304-258-1929
Fax Number	:	304-258-2678

Provider Business Practice Location Address
First Line	:	261 BERKMORE PL
Second Line	:	SUITE 1C
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-6247
Country	:	US
Telephone Number	:	304-258-3800
Fax Number	:	304-258-2670

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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