Provider Demographics
NPI:1447898283
Name:NOURI, SHAWN (PHARMD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:NOURI
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 1:965 BRISTOL PIKE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-8142
Mailing Address - Country:US
Mailing Address - Phone:215-447-8277
Mailing Address - Fax:215-447-8287
Practice Address - Street 1:965 BRISTOL PIKE
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-8142
Practice Address - Country:US
Practice Address - Phone:215-447-8277
Practice Address - Fax:215-447-8287
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist