MEDICARE: MRS. BETH N KERBEL PHARM.D,

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	PR5035	ME

General Provider Information

NPI Number	:	1669665121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETH N KERBEL PHARM.D,

Provider Business Mailing Address
First Line	:	15 SACO AVE
Second Line	:	RITE AID PHARMACY
City	:	OLD ORCHARD BEACH
State	:	ME
Zip	:	04064-2242
Country	:	US
Telephone Number	:	207-934-1000
Fax Number	:	207-934-0921

Provider Business Practice Location Address
First Line	:	15 SACO AVE
Second Line	:	RITE AID PHARMACY
City	:	OLD ORCHARD BEACH
State	:	ME
Zip	:	04064-2242
Country	:	US
Telephone Number	:	207-934-1000
Fax Number	:	207-934-0921

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

Provider Enumeration Date	:	08/19/2007
Last Update Date	:	08/19/2007

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