Provider Demographics
NPI:1275827016
Name:THOMASON, SHANA ASHLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:ASHLEY
Last Name:THOMASON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 8TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1024
Mailing Address - Country:US
Mailing Address - Phone:515-967-1885
Mailing Address - Fax:515-967-1885
Practice Address - Street 1:3414 8TH ST SW
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1024
Practice Address - Country:US
Practice Address - Phone:515-967-1885
Practice Address - Fax:515-967-1885
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist