Provider Demographics
NPI:1548543887
Name:VARUGHESE, SHINY SEBASTIAN
Entity type:Individual
Prefix:
First Name:SHINY
Middle Name:SEBASTIAN
Last Name:VARUGHESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10445 REED ST
Mailing Address - Street 2:T-1928
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6063
Mailing Address - Country:US
Mailing Address - Phone:303-410-8330
Mailing Address - Fax:
Practice Address - Street 1:10445 REED ST
Practice Address - Street 2:T-1928
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6063
Practice Address - Country:US
Practice Address - Phone:303-410-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist