Healthcare Provider Details

I. General information

NPI: 1891398962
Provider Name (Legal Business Name): KRISTINE SHAFER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATIE SHAFER PHARMD

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 COMMERCE LN
KING WILLIAM VA
23086-3662
US

IV. Provider business mailing address

27 COMMERCE LN
KING WILLIAM VA
23086-3662
US

V. Phone/Fax

Practice location:
  • Phone: 804-769-2110
  • Fax: 888-496-4861
Mailing address:
  • Phone: 804-769-2110
  • Fax: 888-496-4861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202215848
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: