Active NPI
Sita Shablack, PHARM.D
- Pharmacist
- Page, AZ
National Provider Identifier
1326473349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S020039
- Practice address
- 650 Elm Street
Page, AZ 86040 - Phone
- (928) 645-5714
- NPI assigned
- Sep 10, 2013
- Last updated
- Sep 10, 2013
- 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 | S020039 | AZ | Primary |
Addresses
Primary practice location
650 Elm Street
Page, AZ 86040
Mailing address
PO Box 1346
Page, AZ 86040-1346
Phone (928) 645-5714
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S020039 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378771200000",
"number": "1326473349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1346",
"city": "PAGE",
"state": "AZ",
"postal_code": "860401346",
"telephone_number": "928-645-5714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 ELM STREET",
"city": "PAGE",
"state": "AZ",
"postal_code": "86040",
"telephone_number": "928-645-5714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHABLACK",
"first_name": "SITA",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-10",
"last_updated": "2013-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S020039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Page, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.