Provider Demographics
NPI:1386920791
Name:REED, AMANDA GRACE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:GRACE
Last Name:REED
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3431
Mailing Address - Country:US
Mailing Address - Phone:610-853-2892
Mailing Address - Fax:
Practice Address - Street 1:1109 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3431
Practice Address - Country:US
Practice Address - Phone:610-446-5245
Practice Address - Fax:610-789-7953
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-30
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI004395183500000X
NJ28RI03327900183500000X
PARP443721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist