Kenneth Bodle
Individual provider Active NPI Pharmacist · Clearfield, PA
NPI 1851968754 · NPPES record last updated Jun 8, 2021
Key facts
- NPI
- 1851968754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP032232L (PA)
- Practice address
- 307 E Market St
Clearfield, PA 16830-2432 - Phone
- (814) 765-7883
- NPI assigned
- Jun 8, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP032232L | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP032232L | PA | Yes |
Addresses
Primary practice location
307 E Market St
Clearfield, PA 16830-2432
Mailing address
112 E Pauline Dr
Clearfield, PA 16830-1014
Other providers in Clearfield, PA
- Katie Bell
- Baren Berg
- Stephanie Lyn Beyer
- Barbara Blakely
- Autumn Hillary Bloom
- Richard O Bolden
- Jamie L Bortot
- Danielle D Boyles
- Emilee Brown
- Dale Alfred Buckwitz Jr.
All providers in Clearfield, PA · Pharmacist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.