Individual ProviderShonisani Patricia MathivhaPharmacistPharmacy Service ProvidersPractice Address1650 N Cedar Crest Blvd, Allentown, PA 18104-2318(610) 395-3671PECOS EnrollmentBased on the most recent information from CMS, provider Shonisani Patricia Mathivha does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1518258557Provider TypeIndividualFull NameMathivha, Shonisani PatriciaTitleMs.CredentialRPHGenderFemaleSole ProprietorNoEnumeration Date4/25/2011Last Updated4/25/2011Contact InformationPractice LocationPractice Address1650 N Cedar Crest Blvd, Allentown, PA 18104-2318Phone(610) 395-3671Fax(610) 395-4486Mailing LocationMailing Address1650 N Cedar Crest Blvd, Allentown, PA 18104-2318Phone(610) 395-3671Fax(610) 395-4486Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseRP1003656PennsylvaniaCode183500000XDescriptionPharmacistPharmacy Service ProvidersLicenseRP443194Pennsylvania