1588939912 NPI number — REED CHIROPRACTIC CLINIC, LLC

Table of content: (NPI 1588939912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588939912 NPI number — REED CHIROPRACTIC CLINIC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REED CHIROPRACTIC CLINIC, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REED CHIROPRACTIC CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588939912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33001 SOLON RD STE 115
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOLON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44139-2864
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-248-2866
Provider Business Mailing Address Fax Number:
440-248-0242

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33001 SOLON RD STE 115
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOLON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44139-2864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-248-2866
Provider Business Practice Location Address Fax Number:
440-248-0242
Provider Enumeration Date:
03/19/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
RANDY
Authorized Official Middle Name:
B
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
440-248-2866

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1197 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0094444 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0625676 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".