Provider Demographics
NPI:1437267069
Name:OBEID, CHARLES J (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:J
Last Name:OBEID
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 E CAREY ST
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-2007
Mailing Address - Country:US
Mailing Address - Phone:570-823-3151
Mailing Address - Fax:570-823-6742
Practice Address - Street 1:79 E CAREY ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-2007
Practice Address - Country:US
Practice Address - Phone:570-823-3151
Practice Address - Fax:570-823-6742
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034482L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00005789130001Medicaid
PA0737690001Medicare ID - Type Unspecified