Provider Demographics
NPI:1760720189
Name:SACHON, SHANNON STEWART (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:STEWART
Last Name:SACHON
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 1:525 S BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6321
Mailing Address - Country:US
Mailing Address - Phone:727-791-0169
Mailing Address - Fax:727-791-0296
Practice Address - Street 1:525 S BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6321
Practice Address - Country:US
Practice Address - Phone:727-791-0169
Practice Address - Fax:727-791-0296
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist