Active NPI
Mita Shah
- Pharmacist
- Bellmawr, NJ
National Provider Identifier
1104109032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03023900
- Practice address
- 12 S Black Horse Pike
Bellmawr, NJ 08031-2305 - Phone
- (856) 933-9342
- NPI assigned
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03023900 | NJ | Primary |
Addresses
Primary practice location
12 S Black Horse Pike
Bellmawr, NJ 08031-2305
Mailing address
9 Adam CT
Monroe, NJ 08831-0167
Phone (732) 521-5310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03023900 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1104109032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 ADAM CT",
"city": "MONROE",
"state": "NJ",
"postal_code": "088310167",
"telephone_number": "732-521-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 S BLACK HORSE PIKE",
"city": "BELLMAWR",
"state": "NJ",
"postal_code": "080312305",
"telephone_number": "856-933-9342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "MITA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-27",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03023900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellmawr, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.