Lisa R Nagle

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP041040L Issued in PA

Practice address

5471 Pottsville Pike
Leesport, PA 19533-8633

Phone

(610) 926-3129

NPI assigned

Oct 18, 2024

Last updated

Oct 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1235950676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 POTTSVILLE PIKE",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338633",
            "telephone_number": "610-926-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 POTTSVILLE PIKE",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338633",
            "telephone_number": "610-926-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "LISA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "RP041040L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Genevieve Beetham Pallas, PT

• Community/Retail Pharmacy in Leesport, PA
• Providers in Leesport, 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 Oct 18, 2024; 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.