Healthcare Provider Details

I. General information

NPI: 1558342568
Provider Name (Legal Business Name): EDWARD BERNARD MAFF JR. R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3463 BIGLERVILLE ROAD
BIGLERVILLE PA
17307-0481
US

IV. Provider business mailing address

11 HEARTHSTONE CT
MECHANICSBURG PA
17050-2700
US

V. Phone/Fax

Practice location:
  • Phone: 717-677-8144
  • Fax: 717-677-9694
Mailing address:
  • Phone: 717-766-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP033052L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: