Provider Demographics
NPI:1174524698
Name:BESHURES, SHREEN MARIE WOJTON (RPH, CGP)
Entity type:Individual
Prefix:MRS
First Name:SHREEN
Middle Name:MARIE WOJTON
Last Name:BESHURES
Suffix:
Gender:F
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10395 BERGTOLD RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-2102
Mailing Address - Country:US
Mailing Address - Phone:716-937-5615
Mailing Address - Fax:
Practice Address - Street 1:11580 WALDEN AVE
Practice Address - Street 2:ERIE COUNTY HOME PHARMACY
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-9715
Practice Address - Country:US
Practice Address - Phone:716-937-5615
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0442021835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy