Shawn Andreasen
Individual provider Active NPI Pharmacist · Rexburg, ID
NPI 1760923635 · NPPES record last updated Mar 13, 2017
Key facts
- NPI
- 1760923635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- P5730 (ID)
- Practice address
- Byu Idaho Student Health Center 179 Ctr
Rexburg, ID 83460-0001 - Phone
- (208) 496-9341
- Fax
- (208) 496-9343
- NPI assigned
- Mar 13, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P5730 | ID | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P5730 | ID | Yes |
Addresses
Primary practice location
Byu Idaho Student Health Center 179 Ctr
Rexburg, ID 83460-0001
Mailing address
Byu Idaho Student Health Center 179 Ctr
Rexburg, ID 83460-0001
Phone (208) 496-9341
Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.