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NPI Code Detail

MEDICARE: MR. JONATHAN P SHELTON R.PH

MEDICARE:  MR. JONATHAN P SHELTON  R.PH
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
1183500000XPharmacistOH

General Provider Information

NPI Number : 1306946074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JONATHAN P SHELTON R.PH
Provider Business Mailing Address
First Line : 1613 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45419-3133
Country : US
Telephone Number : 937-294-2514
Fax Number : 937-253-8662
Provider Business Practice Location Address
First Line : 1613 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45419-3133
Country : US
Telephone Number : 937-294-2514
Fax Number : 937-253-8662
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2006
Last Update Date : 07/08/2007

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Directions to “ MR. JONATHAN P SHELTON R.PH” Practice Location

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