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Individual
SHANE EDWIN HANCOCK
Active
Individual
SHANE EDWIN HANCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7325645-1701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7325645-1701
UTAH STATE PHARMACIST LICENSE
UT
01
—
7325645-8911
UTAH STATE PHARMACIST CONTROLLED SUBSTANCES LICENSE
UT
Enumeration date
04/09/2019
Last updated
04/09/2019
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