| NPI | 1093097206 |
|---|---|
| Doing Business As | SHADELAND PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MAHEN PATEL Member 267-207-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA PP482232) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2014-12-03 |