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NPI Code Detail

MEDICARE: DR. SHANA LEA CASTILLO PHARMD

MEDICARE: DR. SHANA LEA CASTILLO PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist11718NE
2183500000XPharmacist12826AZ

General Provider Information

NPI Number : 1265590731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANA LEA CASTILLO PHARMD
Provider Business Mailing Address
First Line : 5143 DECATUR ST
Second Line :
City : OMAHA
State : NE
Zip : 68104-5024
Country : US
Telephone Number : 402-558-0971
Fax Number :
Provider Business Practice Location Address
First Line : 7151 CASS ST
Second Line :
City : OMAHA
State : NE
Zip : 68132-2652
Country : US
Telephone Number : 402-558-8551
Fax Number : 402-558-8770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/08/2007

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Directions to “ DR. SHANA LEA CASTILLO PHARMD” Practice Location

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