=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497356372
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIENNE STAUFFER PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2020
-----------------------------------------------------
Last Update Date | 11/05/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2030 FRUITVILLE PIKE
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17601-3998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-581-1500
-----------------------------------------------------
Fax | 717-581-7813
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 609 S SPRUCE ST
-----------------------------------------------------
City | LITITZ
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17543-2802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-532-2067
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP447199
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------