Provider Demographics
NPI:1891702262
Name:SHASKY, CHARLES ANDREW (BSCIPHARM, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANDREW
Last Name:SHASKY
Suffix:
Gender:M
Credentials:BSCIPHARM, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9299 MONONGAHELA TRL
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-3389
Mailing Address - Country:US
Mailing Address - Phone:804-550-0415
Mailing Address - Fax:804-550-0415
Practice Address - Street 1:9299 MONONGAHELA TRL
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-3389
Practice Address - Country:US
Practice Address - Phone:804-550-0415
Practice Address - Fax:804-550-0415
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005580183500000X, 1835P1200X, 1835P1300X, 1835X0200X
1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1744R1102XOther Service ProvidersSpecialistResearch Study
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202005580OtherPHARMACIST LICENSE