Shah Afshar, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

P4346 Issued in ID

Practice address

149 W State St
Eagle, ID 83616-4901

Phone

(208) 939-8008

Fax

(208) 938-1067

NPI assigned

Oct 8, 2015

Last updated

Oct 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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.

• Customedica Pharmacy Inc

  dba Customedica Compounding Center

  • Compounding Pharmacy
  • Eagle, ID
  • NPI 1508162454
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1902277536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 W STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164901",
            "telephone_number": "208-939-8008",
            "fax_number": "208-938-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 W STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164901",
            "telephone_number": "208-939-8008",
            "fax_number": "208-938-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFSHAR",
        "first_name": "SHAH",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P4346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Achenbach
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• Jyl E Adams, LCSW
• Anna Albers
• Albertsons LLC (Sav-on Pharmacy #0182)
• Albertsons LLC (Sav-on Pharmacy)
• Sara Aldecoa, RN, IBCLC
• Debbie Joy Aldrich, COTA/L

• Pharmacist in Eagle, ID
• Providers in Eagle, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.