MEDICARE: EDWIN ESPARRA 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	183500000X	Pharmacist	RP033534L	PA

General Provider Information

NPI Number	:	1427481779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWIN ESPARRA RPH

Provider Business Mailing Address
First Line	:	4 BUTTERNUT LN
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-7942
Country	:	US
Telephone Number	:	717-766-0934
Fax Number	:	717-458-3446

Provider Business Practice Location Address
First Line	:	1110 ENTERPRISE RD
Second Line	:
City	:	E PETERSBURG
State	:	PA
Zip	:	17520-1604
Country	:	US
Telephone Number	:	717-925-2380
Fax Number	:	717-925-2399

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

Provider Enumeration Date	:	08/09/2013
Last Update Date	:	08/09/2013

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