Provider Demographics
NPI:1396357448
Name:VALENTINE-SHAFER, MEGAN C (RPH)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:VALENTINE-SHAFER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:C
Other - Last Name:SHAFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:330 MIDDLESEX ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3443
Mailing Address - Country:US
Mailing Address - Phone:413-885-3659
Mailing Address - Fax:
Practice Address - Street 1:2341 MAIN ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-3162
Practice Address - Country:US
Practice Address - Phone:978-988-5534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH237536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPH237536OtherPHARMACIST LICENSE