Healthcare Provider Details

I. General information

NPI: 1629302153
Provider Name (Legal Business Name): MARCIE SHEARN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NOBLESTOWN RD STE 200
CARNEGIE PA
15106-1230
US

IV. Provider business mailing address

500 NOBLESTOWN RD STE 200
CARNEGIE PA
15106-1230
US

V. Phone/Fax

Practice location:
  • Phone: 888-347-3416
  • Fax: 877-231-8302
Mailing address:
  • Phone: 888-347-3416
  • Fax: 877-231-8302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19200
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP444252
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: