Harold Shane Anderson
Pharmacist in Portland, IN. Individual provider (NPI-1).
NPI number1982209722
StatusActive
Last updated in NPPESDec 1, 2020
Details
- NPI
- 1982209722
- Entity type
- Individual (NPI-1)
- Name
- Harold Shane Anderson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 1, 2020
- Certification date
- Dec 1, 2020
- Last updated
- Dec 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 26019299a | IN | Yes |
Practice location
950 W Votaw StPortland, IN 47371-1254
Phone 260-726-3782 · Fax 260-726-3785
Mailing address
950 W Votaw StPortland, IN 47371-1254
Phone 260-726-3782 · Fax 260-726-3785
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