Provider Demographics
NPI:1598013583
Name:SHAH, RAHUL N (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAHUL
Middle Name:N
Last Name:SHAH
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 1:1209 N PEACHTREE PKWY
Mailing Address - Street 2:T-2129
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1743
Mailing Address - Country:US
Mailing Address - Phone:770-282-2166
Mailing Address - Fax:678-734-3840
Practice Address - Street 1:1209 N PEACHTREE PKWY
Practice Address - Street 2:T-2129
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1743
Practice Address - Country:US
Practice Address - Phone:770-282-2166
Practice Address - Fax:678-734-3840
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist