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NPI Code Detail

MEDICARE: GRANT SHAFFER

MEDICARE:   GRANT  SHAFFER
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
1183500000XPharmacist29939NC

General Provider Information

NPI Number : 1023622461
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRANT SHAFFER
Provider Business Mailing Address
First Line : 160 JAMES RD UNIT 1D
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-2397
Country : US
Telephone Number : 410-960-5642
Fax Number :
Provider Business Practice Location Address
First Line : 610 N MAIN ST
Second Line :
City : WALNUT COVE
State : NC
Zip : 27052-9248
Country : US
Telephone Number : 336-591-4351
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2020
Last Update Date : 09/02/2020

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Directions to “ GRANT SHAFFER ” Practice Location

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