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General NPI Number Information
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NPI Number | 1356032346
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Entity Type | Individual
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Provider Name | BRYAN WILLIAM GUSHEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 50 KIRKBRIDE DR
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City | DANVILLE
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State | PA
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Zip | 17821-8630
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Country | US
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Telephone | 570-271-4536
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Fax | 570-271-4537
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Provider Business Mailing Address
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Address Line | 123 MONTANA DR
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City | KULPMONT
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State | PA
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Zip | 17834-1946
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Country | US
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Telephone | 570-205-2952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP446821
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License Number State | PA
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