Provider Demographics
NPI:1063587798
Name:VANVUUREN, SHEA BARBARA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHEA
Middle Name:BARBARA
Last Name:VANVUUREN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16038 BLACK SHEEP LN
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-9480
Mailing Address - Country:US
Mailing Address - Phone:734-428-0230
Mailing Address - Fax:734-593-5905
Practice Address - Street 1:14650 EAST OLD US 12
Practice Address - Street 2:CHELSEACARE PHARMACY
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1383
Practice Address - Country:US
Practice Address - Phone:734-593-5900
Practice Address - Fax:734-593-5905
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist