Healthcare Provider Details

I. General information

NPI: 1194741660
Provider Name (Legal Business Name): SHANKAR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 N BUTTE ST
WILLOWS CA
95988-2804
US

IV. Provider business mailing address

226 N BUTTE ST
WILLOWS CA
95988-2804
US

V. Phone/Fax

Practice location:
  • Phone: 530-934-7744
  • Fax:
Mailing address:
  • Phone: 530-934-7744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47088
License Number StateCA

VIII. Authorized Official

Name: TEJAS PATEL
Title or Position: PRESIDENT
Credential: RPH
Phone: 530-934-7744