Withers, Shane Ellis

Withers, Shane Ellis is an individual health care provider with primary practice located at 164 E. Main , Rexburg ID 83440. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Withers, Shane Ellis can be contacted via phone (208) 227-5076.

Contact Information

Primary practice address
164 E. Main Rexburg ID 83440
Phone: (208) 227-5076
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X P8493 Idaho

Profile Details

NPI number 1952956906
LBN Legal business name Withers, Shane Ellis
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2019
Last updated Nov 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers