Individual provider Active NPI

Peter Albert Kreckel, RPH

  • Pharmacist
  • Altoona, PA
National Provider Identifier
1306057781
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP031811L Issued in PA
Practice address
2329 Broad Ave
Altoona, PA 16601
Phone
(814) 943-1310
Fax
(814) 943-2841
NPI assigned
May 25, 2007
Last updated
Aug 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP031811L PA Primary

Addresses

Primary practice location

2329 Broad Ave
Altoona, PA 16601

Mailing address

2329 Broad Ave
Altoona, PA 16601
Phone (814) 943-1310

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP031811LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Broad Avenue Pharmacy LLC Past Accepting new patients
Broad Avenue Pharmacy LLC PastSince Feb 4, 2024 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1306057781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 BROAD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "16601",
            "telephone_number": "814-943-1310",
            "fax_number": "814-943-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 BROAD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "16601",
            "telephone_number": "814-943-1310",
            "fax_number": "814-943-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRECKEL",
        "first_name": "PETER",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP031811L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.