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General NPI Number Information
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NPI Number | 1154982965
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Entity Type | Individual
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Provider Name | RITABEN DARSHIT SHAH
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Gender | Female
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Dates
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Enumeration Date | 06/23/2019
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 11559 S MAIN ST APT 2
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City | TRENTON
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State | GA
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Zip | 30752-2821
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Country | US
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Telephone | 423-475-2987
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Fax |
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Provider Business Mailing Address
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Address Line | 11969 S MAIN ST
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City | TRENTON
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State | GA
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Zip | 30752-2855
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Country | US
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Telephone | 706-500-1301
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Fax | 706-500-1302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41899
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License Number State | TN
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