Provider Demographics
NPI:1295219749
Name:SHAH, ASHINI PARESH
Entity Type:Individual
Prefix:
First Name:ASHINI
Middle Name:PARESH
Last Name:SHAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 S BOULDER ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3776
Mailing Address - Country:US
Mailing Address - Phone:909-740-4347
Mailing Address - Fax:
Practice Address - Street 1:2363 S LINDSAY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4744
Practice Address - Country:US
Practice Address - Phone:480-857-1801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist