Provider Demographics
NPI:1518567379
Name:NOEL, GREGORY THOMAS
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:THOMAS
Last Name:NOEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ASHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17340-9527
Mailing Address - Country:US
Mailing Address - Phone:717-451-1127
Mailing Address - Fax:
Practice Address - Street 1:495 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5215
Practice Address - Country:US
Practice Address - Phone:717-632-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034216L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist