Provider Demographics
NPI:1265941181
Name:JANOVICH, SHELLEY LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:LYNN
Last Name:JANOVICH
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 1:234 HAWTHORN RD
Mailing Address - Street 2:
Mailing Address - City:CLAYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15323-1027
Mailing Address - Country:US
Mailing Address - Phone:724-350-4557
Mailing Address - Fax:
Practice Address - Street 1:1100 W CHESTNUT ST STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4631
Practice Address - Country:US
Practice Address - Phone:724-223-7710
Practice Address - Fax:724-223-7712
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041477L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist