MEDICARE: CHARLES LAMONT REED

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	343900000X	Non-emergency Medical Transport (VAN)	SD168712	OH

General Provider Information

NPI Number	:	1689455123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES LAMONT REED

Provider Business Mailing Address
First Line	:	4488 W 45TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-3904
Country	:	US
Telephone Number	:	216-926-2289
Fax Number	:

Provider Business Practice Location Address
First Line	:	4488 W 45TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-3904
Country	:	US
Telephone Number	:	216-926-2289
Fax Number	:

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

Provider Enumeration Date	:	10/10/2023
Last Update Date	:	10/10/2023

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Directions to “ CHARLES LAMONT REED ” Practice Location

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