Provider Demographics
NPI:1669665121
Name:KERBEL, BETH N (PHARMD,)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:N
Last Name:KERBEL
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 1:15 SACO AVE
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:OLD ORCHARD BEACH
Mailing Address - State:ME
Mailing Address - Zip Code:04064-2242
Mailing Address - Country:US
Mailing Address - Phone:207-934-1000
Mailing Address - Fax:207-934-0921
Practice Address - Street 1:15 SACO AVE
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:OLD ORCHARD BEACH
Practice Address - State:ME
Practice Address - Zip Code:04064-2242
Practice Address - Country:US
Practice Address - Phone:207-934-1000
Practice Address - Fax:207-934-0921
Is Sole Proprietor?:No
Enumeration Date:2007-08-19
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0514202800Medicare PIN