Gayla S Mitchell, PHARMACH TECHNICIAN

Key facts

NPI

1003832064

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacy Technician 183700000X

Practice address

4241 Hwy 14 W
Rea Clinic Pharmacy
Christopher, IL 62822

Phone

(618) 724-2136

Fax

(618) 724-2571

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003832064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "address_2": "REA CLINIC PHARMACY",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2136",
            "fax_number": "618-724-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 HWY 14 W",
            "address_2": "REA CLINIC PHARMACY",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62822",
            "telephone_number": "618-724-2136",
            "fax_number": "618-724-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GAYLA",
        "middle_name": "S",
        "credential": "PHARMACH TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christopher, IL

• Rebecca McMurray, LPN
• Sarah Sue Menckowski
• Cynthia A Metcalf, RN
• Elizabeth A Michaels, MS RDN LDN
• Sarah Miner, RN
• Lori Mohr, HYGENIST
• Olivia B Montgomery, LPHT
• Brittany Morris, LPN
• Frances Fischer Morris, REGISTERED PHARMACIS
• Robert Moskoff

All providers in Christopher, IL · Pharmacy Technician in Illinois