Provider Demographics
NPI:1902026172
Name:DEIBLER, JAMES THOMAS (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:DEIBLER
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 1:90 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NY
Mailing Address - Zip Code:14892-1137
Mailing Address - Country:US
Mailing Address - Phone:607-565-7254
Mailing Address - Fax:
Practice Address - Street 1:1 GUTHRIE SQUARE
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-882-2830
Practice Address - Fax:570-882-2072
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028741L1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric