Cheyenne Courson
Individual provider Active NPI Pharmacist · Enola, PA
NPI 1548030216 · NPPES record last updated Jan 4, 2024
Key facts
- NPI
- 1548030216
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP458165 (PA)
- Practice address
- 744 Wertzville Rd
Enola, PA 17025-2044 - Phone
- (717) 728-4701
- NPI assigned
- Jan 4, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP458165 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP458165 | PA | Yes |
Addresses
Primary practice location
744 Wertzville Rd
Enola, PA 17025-2044
Mailing address
3261 Vesta LN
Harrisburg, PA 17110-9170
Phone (239) 745-1245
Other providers in Enola, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.