MEDICARE: DIANE ANDRAKO SHASKY B.SCI.PHARM.

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	0202005065	VA
2	1835X0200X	Oncology Pharmacist	0202005065	VA

General Provider Information

NPI Number	:	1710165584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE ANDRAKO SHASKY B.SCI.PHARM.

Provider Business Mailing Address
First Line	:	9299 MONONGAHELA TRL
Second Line	:
City	:	ASHLAND
State	:	VA
Zip	:	23005-3389
Country	:	US
Telephone Number	:	804-828-9952
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 W MARSHALL ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-3025
Country	:	US
Telephone Number	:	804-828-9952
Fax Number	:

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

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	02/04/2008

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