MEDICARE: ADITI SHAH 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
1	183500000X	Pharmacist	15868-040	WI

General Provider Information

NPI Number	:	1295002954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADITI SHAH PHARMD

Provider Business Mailing Address
First Line	:	6210 W LOOMIS RD
Second Line	:
City	:	GREENDALE
State	:	WI
Zip	:	53129-2448
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6210 W LOOMIS RD
Second Line	:
City	:	GREENDALE
State	:	WI
Zip	:	53129-2448
Country	:	US
Telephone Number	:	414-423-1485
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2011
Last Update Date	:	11/23/2011

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Directions to “ ADITI SHAH PHARMD” Practice Location

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