Tyler Nathaniel Lieberum, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP453758 Issued in PA

Practice address

801 Baltimore St
Hanover, PA 17331-4100

Phone

(717) 633-7292

NPI assigned

Nov 20, 2020

Sex

Male

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• The Giant Company, LLC

  • Community/Retail Pharmacy
  • Hanover, PA
  • NPI 1780619833
  NPD (past)
• The Giant Company, LLC

  • Community/Retail Pharmacy
  • Quarryville, PA
  • NPI 1952182305
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1760085807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BALTIMORE ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173314100",
            "telephone_number": "717-633-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BALTIMORE ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173314100",
            "telephone_number": "717-633-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERUM",
        "first_name": "TYLER",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP453758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa S Leathery, LSW
• Whitney Lehman, LAPC
• Edward K Leventhal, M.D.
• Danielle Lew, LCSW-C
• John G Lieb, M.D.
• Life Change Specialties L L C
• Lifenet Emergency Medical Services, Inc.
• Jara M Lighty, LMT
• Jordon Philip Limsky, DO
• Linda Ying Lin, PA-C

• All providers in Hanover, PA
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.