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NPI Code Detail

MEDICARE: TERRENCE EUGENE O'SHEA PHARM.D., CGP

MEDICARE: TERRENCE EUGENE O'SHEA PHARM.D., CGP
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
1183500000XPharmacist03-3-16904OH

General Provider Information

NPI Number : 1710929955
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRENCE EUGENE O'SHEA PHARM.D., CGP
Provider Business Mailing Address
First Line : 11365 PUTNAM RD
Second Line :
City : ENGLEWOOD
State : OH
Zip : 45322-9765
Country : US
Telephone Number : 937-832-1710
Fax Number : 937-836-1209
Provider Business Practice Location Address
First Line : 600 UNION BLVD
Second Line :
City : ENGLEWOOD
State : OH
Zip : 45322-2121
Country : US
Telephone Number : 937-771-2484
Fax Number : 937-836-1209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 07/08/2007

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