Provider Demographics
NPI:1821437724
Name:SCHAFFER, JANINE INGA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:INGA
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4253 47TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4244
Mailing Address - Country:US
Mailing Address - Phone:701-306-5294
Mailing Address - Fax:
Practice Address - Street 1:706 38TH ST NW
Practice Address - Street 2:UNIT E
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2953
Practice Address - Country:US
Practice Address - Phone:701-893-9183
Practice Address - Fax:701-893-9184
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118155183500000X
ND4969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist