Healthcare Provider Details

I. General information

NPI: 1992309447
Provider Name (Legal Business Name): AUSTIN SHAEFFER CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 11/25/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 LITITZ PIKE
LANCASTER PA
17601-6505
US

IV. Provider business mailing address

1507 LITITZ PIKE
LANCASTER PA
17601-6505
US

V. Phone/Fax

Practice location:
  • Phone: 717-330-2398
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number30109884
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: