Provider Demographics
NPI:1801166996
Name:SHANK, BARBARA (RPH)
Entity type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:
Last Name:SHANK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 HARBOR WAY APT 1643
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3765
Mailing Address - Country:US
Mailing Address - Phone:727-596-3247
Mailing Address - Fax:
Practice Address - Street 1:11340 HARBOR WAY APT 1643
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3765
Practice Address - Country:US
Practice Address - Phone:727-596-3247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist