MEDICARE: MARK A REED DPH

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	4539	TN

General Provider Information

NPI Number	:	1780784637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A REED DPH

Provider Business Mailing Address
First Line	:	105 BROYLES ST
Second Line	:	STE A
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-2542
Country	:	US
Telephone Number	:	423-282-1178
Fax Number	:	423-282-0462

Provider Business Practice Location Address
First Line	:	105 BROYLES ST
Second Line	:	STE A
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-2542
Country	:	US
Telephone Number	:	423-282-1178
Fax Number	:	423-282-0462

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	05/20/2013

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Directions to “ MARK A REED DPH” Practice Location

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