Provider Demographics
NPI:1760085336
Name:GOBEILLE, THOMAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:GOBEILLE
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 1:287 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-1555
Mailing Address - Country:US
Mailing Address - Phone:413-786-4100
Mailing Address - Fax:413-786-5996
Practice Address - Street 1:287 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-1555
Practice Address - Country:US
Practice Address - Phone:413-786-4100
Practice Address - Fax:413-786-5996
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist