Provider Demographics
NPI:1902827637
Name:SHAH, HARISH SHANTILAL (RPH)
Entity Type:Individual
Prefix:
First Name:HARISH
Middle Name:SHANTILAL
Last Name:SHAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:HARISH
Other - Middle Name:S
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:100 GLENIFFER HILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1367
Mailing Address - Country:US
Mailing Address - Phone:215-953-9360
Mailing Address - Fax:
Practice Address - Street 1:100 GLENIFFER HILL RD
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1367
Practice Address - Country:US
Practice Address - Phone:215-953-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028632L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist