Provider Demographics
NPI:1902527294
Name:SHAVER HOLDINGS INC
Entity Type:Organization
Organization Name:SHAVER HOLDINGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:TORI
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-235-7243
Mailing Address - Street 1:235 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6438
Mailing Address - Country:US
Mailing Address - Phone:208-235-7243
Mailing Address - Fax:208-235-7277
Practice Address - Street 1:235 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6438
Practice Address - Country:US
Practice Address - Phone:208-235-7243
Practice Address - Fax:208-235-7277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAVER HOLDINGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy