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Organization

RUSSEL ALAN GOBEILLE

Active
Other names
BEWARD PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSELL GOBEILLE RPH (OWNER)
(717) 436-6844
Entity
Organization

Contact information

Practice address
27 CJEMS LANE, MIFFLINTOWN, PA 17059
(717) 436-6844
(717) 436-6644
Mailing address
PO BOX 192, MIFFLINTOWN, PA 17059-0192
(717) 436-6844
(717) 436-6644

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PP410186L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000950066
PA
01
3919834
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
08/20/2006
Last updated
08/25/2009
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