Provider Demographics
NPI:1538769476
Name:GENSIC REED, BARBARA LYNN (RPH)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:GENSIC REED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5284 S 775 E
Mailing Address - Street 2:
Mailing Address - City:PIERCETON
Mailing Address - State:IN
Mailing Address - Zip Code:46562-9775
Mailing Address - Country:US
Mailing Address - Phone:260-823-0020
Mailing Address - Fax:
Practice Address - Street 1:402 W PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1051
Practice Address - Country:US
Practice Address - Phone:260-244-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018586A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist