Provider Demographics
NPI:1508141086
Name:SHIH, JIMMY Y (RPH)
Entity Type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:Y
Last Name:SHIH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12051 E MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2834
Mailing Address - Country:US
Mailing Address - Phone:303-340-8860
Mailing Address - Fax:
Practice Address - Street 1:12051 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2834
Practice Address - Country:US
Practice Address - Phone:303-340-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist