MEDICARE: REID PHYSICIAN ASSOCIATES, INC.

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1912242744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REID PHYSICIAN ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	1100 REID PKWY
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1157
Country	:	US
Telephone Number	:	765-935-8807
Fax Number	:	765-983-3219

Provider Business Practice Location Address
First Line	:	1501 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1914
Country	:	US
Telephone Number	:	765-935-1905
Fax Number	:	765-935-1910

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MISTY NASH
Credential	:	CPCS
Telephone Number	:	765-935-8807

Provider Enumeration Date	:	12/05/2012
Last Update Date	:	10/30/2019

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