Provider Demographics
NPI:1922353721
Name:SHAW, LAWRENCE EUGENE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:EUGENE
Last Name:SHAW
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2601 ARGONNE DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3599
Mailing Address - Country:US
Mailing Address - Phone:785-827-4455
Mailing Address - Fax:785-827-5847
Practice Address - Street 1:601 E IRON AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3035
Practice Address - Country:US
Practice Address - Phone:785-827-4455
Practice Address - Fax:785-827-5847
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-09993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist