Provider Demographics
NPI:1609188309
Name:SHAH, HEMANGI D (RPH, MS)
Entity Type:Individual
Prefix:
First Name:HEMANGI
Middle Name:D
Last Name:SHAH
Suffix:
Gender:F
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 AMBOY AVENUE
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837
Mailing Address - Country:US
Mailing Address - Phone:732-494-0677
Mailing Address - Fax:732-452-0523
Practice Address - Street 1:1199 AMBOY AVENUE
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837
Practice Address - Country:US
Practice Address - Phone:732-494-0677
Practice Address - Fax:732-452-0523
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02971900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist