MEDICARE: HARRY M SHIFTON PHARMACIST

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	022057	NY

General Provider Information

NPI Number	:	1700849957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRY M SHIFTON PHARMACIST

Provider Business Mailing Address
First Line	:	76 TALAMORA TRL
Second Line	:
City	:	BROCKPORT
State	:	NY
Zip	:	14420-3000
Country	:	US
Telephone Number	:	585-637-3548
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 WEST AVE
Second Line	:
City	:	BROCKPORT
State	:	NY
Zip	:	14420-1229
Country	:	US
Telephone Number	:	585-395-6043
Fax Number	:

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/08/2007

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