Provider Demographics
NPI:1730391251
Name:PETERS, JOSEPHINE CHASARA (RPH)
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:CHASARA
Last Name:PETERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3597 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2689
Mailing Address - Country:US
Mailing Address - Phone:717-732-5191
Mailing Address - Fax:717-732-5191
Practice Address - Street 1:5277 SIMPSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3515
Practice Address - Country:US
Practice Address - Phone:717-766-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15119815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist