NPIMap

Individual provider Active NPI

Courtney Lyn Madl

  • Pharmacist
  • Berwick, PA
National Provider Identifier
1750680237
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP439735 Issued in PA
Practice address
400 W 2ND St
Berwick, PA 18603-4635
Phone
(570) 752-5200
NPI assigned
Mar 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP439735 PA Primary
Pharmacist 183500000X PH25821 MA

Addresses

Primary practice location

400 W 2ND St
Berwick, PA 18603-4635

Mailing address

918 E 5TH St
Berwick, PA 18603-3410
Phone (570) 417-8579

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

State licenses

LicenseStateTypeSpecialty
PH25821MAMDPharmacist
RP439735PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1750680237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 E 5TH ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186033410",
            "telephone_number": "570-417-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 2ND ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186034635",
            "telephone_number": "570-752-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADL",
        "first_name": "COURTNEY",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP439735",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH25821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwick, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.