Provider Demographics
NPI:1265564603
Name:GOOD, CHRIS R (RPH)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:R
Last Name:GOOD
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 1:315 LUZERNE ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2321
Mailing Address - Country:US
Mailing Address - Phone:814-536-6661
Mailing Address - Fax:
Practice Address - Street 1:550 LOCUST ST
Practice Address - Street 2:
Practice Address - City:ST MICHAEL
Practice Address - State:PA
Practice Address - Zip Code:15915
Practice Address - Country:US
Practice Address - Phone:814-495-7127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035952L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist