Shady K Basta

NPI #1972770766 in Manchester, Pennsylvania

Provider Information

NPI Number: 1972770766
Entity Type: Individual
Name: Shady K Basta
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: May 12, 2008
Last Updated: May 12, 2008

Practice Location

Address: 4135 N GEORGE STREET EXT
City: Manchester
State: Pennsylvania
ZIP Code: 17345-9208
Phone: (717) 266-6609

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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