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General NPI Number Information
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NPI Number | 1184726440
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Entity Type | Individual
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Provider Name | TRACEY ANN SHEARER R.PH.
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 3180 CARLISLE RD
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City | DOVER
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State | PA
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Zip | 17315-4512
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Country | US
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Telephone | 717-767-5322
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Fax |
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Provider Business Mailing Address
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Address Line | 16 DICKEN DR
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City | MARYSVILLE
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State | PA
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Zip | 17053-9702
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Country | US
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Telephone | 717-957-0146
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 04-105066
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License Number State | PA
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