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NPI Code Detail

MEDICARE: MR. SANJAYKUMAR KANTILAL SHAH RPH

MEDICARE: MR. SANJAYKUMAR KANTILAL SHAH RPH
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
1183500000XPharmacistPS 43160FL
2183500000XPharmacist45819TX

General Provider Information

NPI Number : 1679747349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SANJAYKUMAR KANTILAL SHAH RPH
Provider Business Mailing Address
First Line : 1903 STATE ROAD 60 E
Second Line :
City : LAKE WALES
State : FL
Zip : 33853-4329
Country : US
Telephone Number : 863-676-9496
Fax Number : 863-678-1829
Provider Business Practice Location Address
First Line : 1903 STATE ROAD 60 E
Second Line :
City : LAKE WALES
State : FL
Zip : 33853-4329
Country : US
Telephone Number : 863-676-9496
Fax Number : 863-678-1829
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2008
Last Update Date : 04/14/2008

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Directions to “ MR. SANJAYKUMAR KANTILAL SHAH RPH” Practice Location

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