MEDICARE: TROY REED QMHS

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1689132821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY REED QMHS

Provider Business Mailing Address
First Line	:	4041 TAMARACK AVE
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123
Country	:	US
Telephone Number	:	614-546-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4086 BROADWAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-3025
Country	:	US
Telephone Number	:	614-546-8400
Fax Number	:	614-957-4043

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

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	03/06/2019

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