Provider Demographics
NPI:1538100227
Name:AUCOIN, SHAWN JOSEPH (RPH)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:JOSEPH
Last Name:AUCOIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 N 200 E
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4603
Mailing Address - Country:US
Mailing Address - Phone:435-213-3757
Mailing Address - Fax:
Practice Address - Street 1:1150 S 100 W
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-5573
Practice Address - Country:US
Practice Address - Phone:435-787-4143
Practice Address - Fax:435-787-4176
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5140587-1701183500000X
LA16831183500000X
MSE-09140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist