MEDICARE: BETH PFEIFFER RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03120815	OH

General Provider Information

NPI Number	:	1417482563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH PFEIFFER RPH

Provider Business Mailing Address
First Line	:	1240 PARK AVE W
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-2814
Country	:	US
Telephone Number	:	419-528-1862
Fax Number	:	419-528-1864

Provider Business Practice Location Address
First Line	:	1240 PARK AVE W
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-2814
Country	:	US
Telephone Number	:	419-589-3693
Fax Number	:	419-589-3693

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	06/17/2026

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