Provider Demographics
NPI:1609102854
Name:SHAH, GIRISH (PHARM D)
Entity type:Individual
Prefix:
First Name:GIRISH
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
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 1:200 SWANTON ST
Mailing Address - Street 2:APT#337
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1962
Mailing Address - Country:US
Mailing Address - Phone:339-222-9075
Mailing Address - Fax:
Practice Address - Street 1:200 SWANTON ST
Practice Address - Street 2:APT#337
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1962
Practice Address - Country:US
Practice Address - Phone:339-222-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232422183500000X
VT033.0047602183500000X
NHR2129183500000X
MEPR5714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist