Provider Demographics
NPI:1033491659
Name:SHEEHAN, EDWARD JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 STILES RD STE 102C
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2893
Mailing Address - Country:US
Mailing Address - Phone:603-458-6944
Mailing Address - Fax:603-696-3386
Practice Address - Street 1:32 STILES RD STE 102C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2893
Practice Address - Country:US
Practice Address - Phone:034-586-9446
Practice Address - Fax:603-458-6944
Is Sole Proprietor?:No
Enumeration Date:2011-09-10
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH21841183500000X
NHPHCY-01136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist