MEDICARE: SHEEHANS PHARMACY INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP412266L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3909136	OTHER		OTHER ID NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639399330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEEHANS PHARMACY INC

Provider Business Mailing Address
First Line	:	79 E CAREY ST
Second Line	:
City	:	PLAINS
State	:	PA
Zip	:	18705-2007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	79 E CAREY ST
Second Line	:
City	:	PLAINS
State	:	PA
Zip	:	18705-2007
Country	:	US
Telephone Number	:	570-823-3151
Fax Number	:	570-823-6742

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHARLES OBEID
Credential	:	RPH
Telephone Number	:	570-823-3151

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	08/31/2007

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Directions to “SHEEHANS PHARMACY INC ” Practice Location

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