Basic Information
| Provider Information | |||||||||
| NPI: | 1821670746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 WILLOW CREEK DR | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490158341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699638256 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5500 ARMSTRONG RD | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490377314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699665600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2021 | ||||||||
| LastUpdateDate: | 04/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 5303028021 | MI | Y | Pharmacy Service Providers | Pharmacy Technician |
ID Information
| ID | Type | State | Issuer | Description | 30161950 | 01 | MI | PTCB | OTHER |