Provider Demographics
NPI:1376860536
Name:MASKARINEC, SHELBY JEAN (RPH)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:JEAN
Last Name:MASKARINEC
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 1:1396 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5803
Mailing Address - Country:US
Mailing Address - Phone:724-228-0059
Mailing Address - Fax:
Practice Address - Street 1:1396 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5803
Practice Address - Country:US
Practice Address - Phone:724-228-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036405R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist