Provider Demographics
NPI:1578807582
Name:BADIE, SHAHENE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAHENE
Middle Name:
Last Name:BADIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 N CENTRAL AVE STE 2300
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2536
Mailing Address - Country:US
Mailing Address - Phone:602-337-5700
Mailing Address - Fax:
Practice Address - Street 1:3300 N CENTRAL AVE STE 2300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2536
Practice Address - Country:US
Practice Address - Phone:602-337-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist