Provider Demographics
NPI:1346615028
Name:SHAH, RAHUL (PHARM D)
Entity type:Individual
Prefix:MR
First Name:RAHUL
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 1:6 WOODLAND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-9501
Mailing Address - Country:US
Mailing Address - Phone:707-963-5209
Mailing Address - Fax:707-967-5615
Practice Address - Street 1:6 WOODLAND RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-9501
Practice Address - Country:US
Practice Address - Phone:707-963-5209
Practice Address - Fax:707-967-5615
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46364183500000X
VA0202215548183500000X
TN0000040908183500000X
CA64373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist