Russel Alan Gobeille

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410186L Issued in PA

Legal business name

RUSSEL ALAN GOBEILLE

Doing business as

BEWARD PHARMACY

Practice address

27 Cjems Lane
Mifflintown, PA 17059

Phone

(717) 436-6844

Fax

(717) 436-6644

NPI assigned

Aug 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Russell Gobeille, RPH

Title

Owner

Phone

(717) 436-6844

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BEWARD PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1023123064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "MIFFLINTOWN",
            "state": "PA",
            "postal_code": "170590192",
            "telephone_number": "717-436-6844",
            "fax_number": "717-436-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CJEMS LANE",
            "city": "MIFFLINTOWN",
            "state": "PA",
            "postal_code": "17059",
            "telephone_number": "717-436-6844",
            "fax_number": "717-436-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSEL ALAN GOBEILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "GOBEILLE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-436-6844",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410186L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3919834",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000950066",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEWARD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brendon Isaac Ian Polson
• Heather Sue Pyle, PA-C
• Lilli Josephine Reed, COTA/L
• Meri Andrea Richardson, LSW
• Nathan Rosahac
• Guy R Schenker, D.C.
• Stephanie Nicole Schlegel, PHARMD
• Cherechi Godswill Sike, M.D.
• Sunmeet Singh, MD
• Andrea Smith, DO

• Community/Retail Pharmacy in Mifflintown, PA
• Providers in Mifflintown, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.