Provider Demographics
NPI:1174112809
Name:SHRAWDER, MARY CATHERINE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:SHRAWDER
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:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-0286
Mailing Address - Country:US
Mailing Address - Phone:803-347-6270
Mailing Address - Fax:
Practice Address - Street 1:11798 ROUTE 6
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-6753
Practice Address - Country:US
Practice Address - Phone:570-724-6453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician