Provider Demographics
NPI:1699446021
Name:SHAFFER, VINCENT ANDREW (PHARMD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:ANDREW
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 CONSTITUTION BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1276
Mailing Address - Country:US
Mailing Address - Phone:724-843-3922
Mailing Address - Fax:
Practice Address - Street 1:2650 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1276
Practice Address - Country:US
Practice Address - Phone:724-843-3922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist