Provider Demographics
NPI:1972844504
Name:SAUBELS MARKET INC
Entity Type:Organization
Organization Name:SAUBELS MARKET INC
Other - Org Name:SAUBELS PHARMACY SHREWSBURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-880-9313
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:65 E. FORREST AVE
Mailing Address - City:STEWARTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17363-0397
Mailing Address - Country:US
Mailing Address - Phone:717-993-9166
Mailing Address - Fax:717-993-0886
Practice Address - Street 1:65 E FORREST AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1402
Practice Address - Country:US
Practice Address - Phone:717-235-7720
Practice Address - Fax:717-235-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4823653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139219OtherPK
PA1028063500001Medicaid