Provider Demographics
NPI:1518966514
Name:SHAH, KUSHAL B (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KUSHAL
Middle Name:B
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-5068
Mailing Address - Country:US
Mailing Address - Phone:412-443-0033
Mailing Address - Fax:
Practice Address - Street 1:201 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2705
Practice Address - Country:US
Practice Address - Phone:717-393-3814
Practice Address - Fax:717-393-7537
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439891183500000X
VA0202207138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist