Provider Demographics
NPI:1861816035
Name:PATEL, SHIMA (PHARM D)
Entity Type:Individual
Prefix:
First Name:SHIMA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 EUREKA TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-1031
Mailing Address - Country:US
Mailing Address - Phone:636-938-9425
Mailing Address - Fax:
Practice Address - Street 1:1435 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MO
Practice Address - Zip Code:63077-1033
Practice Address - Country:US
Practice Address - Phone:636-629-8085
Practice Address - Fax:636-629-8084
Is Sole Proprietor?:No
Enumeration Date:2014-02-09
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007025640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist