Individual provider Active NPI

Glenn Wilson Boerstler, BS RPH

  • Pharmacist
  • Bethlehem, PA
National Provider Identifier
1235246455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP022649L Issued in PA
Practice address
39 E Elizabeth Ave
Bethlehem, PA 18018-6505
Phone
(610) 866-5037
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP022649L PA Primary

Addresses

Primary practice location

39 E Elizabeth Ave
Bethlehem, PA 18018-6505

Mailing address

39 E Elizabeth Ave
Bethlehem, PA 18018-6505
Phone (610) 866-5037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP022649LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Boerstlers Pharmacy Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235246455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 E ELIZABETH AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186505",
            "telephone_number": "610-866-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 E ELIZABETH AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186505",
            "telephone_number": "610-866-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERSTLER",
        "first_name": "GLENN",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "credential": "BS RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP022649L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.