Provider Demographics
NPI:1932587532
Name:MEHRE, SHAVINA
Entity Type:Individual
Prefix:
First Name:SHAVINA
Middle Name:
Last Name:MEHRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SMOKE RISE RD
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-1871
Mailing Address - Country:US
Mailing Address - Phone:609-216-3264
Mailing Address - Fax:
Practice Address - Street 1:150 SMOKE RISE RD
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-1871
Practice Address - Country:US
Practice Address - Phone:609-216-3264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ28RS00448900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist