Provider Demographics
NPI:1730337841
Name:VIRKAR, SHASHANK ANIL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHASHANK
Middle Name:ANIL
Last Name:VIRKAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 EAST 2100 SOUTH #841
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106
Mailing Address - Country:US
Mailing Address - Phone:801-243-0408
Mailing Address - Fax:
Practice Address - Street 1:1155 E 2100 S
Practice Address - Street 2:#841
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2872
Practice Address - Country:US
Practice Address - Phone:801-243-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT375492-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist