Provider Demographics
NPI:1073751475
Name:BEPPLER, GARY ADAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ADAM
Last Name:BEPPLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SMALLACOMBE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2616
Mailing Address - Country:US
Mailing Address - Phone:570-702-8700
Mailing Address - Fax:
Practice Address - Street 1:201 SMALLACOMBE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2616
Practice Address - Country:US
Practice Address - Phone:570-702-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist