MEDICARE: MRS. MARY BETH FRABLE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP028072L	PA

General Provider Information

NPI Number	:	1144533852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY BETH FRABLE RPH

Provider Business Mailing Address
First Line	:	215 SOUTH BROAD ST.
Second Line	:	RITEAID PHARMACY STORE 1365
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5325
Country	:	US
Telephone Number	:	215-735-3593
Fax Number	:	215-790-0146

Provider Business Practice Location Address
First Line	:	215 SOUTH BROAD ST.
Second Line	:	RITEAID PHARMACY STORE 1365
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5325
Country	:	US
Telephone Number	:	215-735-3593
Fax Number	:	215-790-0146

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	07/22/2010

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