Provider Demographics
NPI:1437287240
Name:SHAW NEAL INVESTMENTS INC.
Entity Type:Organization
Organization Name:SHAW NEAL INVESTMENTS INC.
Other - Org Name:MEDICINEMART WESTSIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-966-9672
Mailing Address - Street 1:3910 SUMMITVIEW AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2780
Mailing Address - Country:US
Mailing Address - Phone:509-966-9672
Mailing Address - Fax:509-972-8324
Practice Address - Street 1:3910 SUMMITVIEW AVE STE 140
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2780
Practice Address - Country:US
Practice Address - Phone:509-966-9672
Practice Address - Fax:509-972-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF00002785333600000X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0004XSuppliersPharmacyCompounding Pharmacy