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Individual
DR. DALE SHAW
Active
Individual
DR. DALE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0007589
OR
183500000X
Pharmacist
Primary
S021072
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0007589
PHARMACY LICENSE
OR
01
—
S021072
PHARMACY LICENSE
AZ
Enumeration date
07/08/2015
Last updated
07/08/2015
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