Provider Demographics
NPI:1336384379
Name:AMER, AMRO SHAKKER (RPH)
Entity type:Individual
Prefix:
First Name:AMRO
Middle Name:SHAKKER
Last Name:AMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 BURTON MESA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1400
Mailing Address - Country:US
Mailing Address - Phone:805-733-2060
Mailing Address - Fax:805-733-2061
Practice Address - Street 1:191 BURTON MESA BLVD STE A
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-1400
Practice Address - Country:US
Practice Address - Phone:805-733-2060
Practice Address - Fax:805-733-2061
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist