MEDICARE: DR. AMI TEAGUE SHELL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	14031	AL

General Provider Information

NPI Number	:	1033113923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMI TEAGUE SHELL PHARMD

Provider Business Mailing Address
First Line	:	203 MALAGA AVE
Second Line	:
City	:	HOMEWOOD
State	:	AL
Zip	:	35209-2026
Country	:	US
Telephone Number	:	205-871-8198
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 LAKESHORE DR
Second Line	:	MCWHORTER SCHOOL OF PHARMACY
City	:	BIRMINGHAM
State	:	AL
Zip	:	35229-0001
Country	:	US
Telephone Number	:	205-726-4367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	04/10/2013

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