Provider Demographics
NPI:1588360341
Name:GILBERT, CRYSTAL MARIE (RPH)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:MARIE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 YEAGLE RD
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-8926
Mailing Address - Country:US
Mailing Address - Phone:570-419-8828
Mailing Address - Fax:
Practice Address - Street 1:68 SPRING ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-1911
Practice Address - Country:US
Practice Address - Phone:570-263-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043593T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist