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NPI Code Detail

MEDICARE: TERESA LEA SHAFFER RPH

MEDICARE: TERESA LEA SHAFFER 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
1183500000XPharmacist26018941AIN

General Provider Information

NPI Number : 1942583281
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA LEA SHAFFER RPH
Provider Business Mailing Address
First Line : 6310 FOREST GROVE DR NE
Second Line :
City : GEORGETOWN
State : IN
Zip : 47122-7764
Country : US
Telephone Number : 812-366-3369
Fax Number :
Provider Business Practice Location Address
First Line : 6310 FOREST GROVE DR NE
Second Line :
City : GEORGETOWN
State : IN
Zip : 47122-7764
Country : US
Telephone Number : 812-366-3369
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 09/22/2011

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Directions to “ TERESA LEA SHAFFER RPH” Practice Location

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