MEDICARE: SHAUNNA MICHELE RECHSTEINER 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	369477	UT

General Provider Information

NPI Number	:	1871526921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUNNA MICHELE RECHSTEINER RPH

Provider Business Mailing Address
First Line	:	PO BOX 664
Second Line	:
City	:	PANGUITCH
State	:	UT
Zip	:	84759-0664
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 EAST CENTER STREET
Second Line	:
City	:	PANGUITCH
State	:	UT
Zip	:	84759
Country	:	US
Telephone Number	:	435-676-2212
Fax Number	:	435-676-8850

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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