Provider Demographics
NPI:1417014325
Name:GOBELI, BRANDI RAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:RAE
Last Name:GOBELI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20759 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-9470
Mailing Address - Country:US
Mailing Address - Phone:641-424-4990
Mailing Address - Fax:
Practice Address - Street 1:621 S ILLINOIS AVE STE 104
Practice Address - Street 2:MERCY LONG TERM CARE PHARMACY
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-5489
Practice Address - Country:US
Practice Address - Phone:641-422-6944
Practice Address - Fax:641-422-6946
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist