Provider Demographics
NPI:1568532216
Name:ABU-SHANAB, JOY RENAE (PHARM D, BCPS)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:RENAE
Last Name:ABU-SHANAB
Suffix:
Gender:F
Credentials:PHARM D, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615 S NEW BALLAS RD
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8221
Mailing Address - Country:US
Mailing Address - Phone:314-251-4767
Mailing Address - Fax:314-251-4943
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-4767
Practice Address - Fax:314-251-4943
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO0453201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy