Healthcare Provider Details

I. General information

NPI: 1184236846
Provider Name (Legal Business Name): ANNA SHELL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2020
Last Update Date: 08/23/2020
Certification Date: 08/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 DUG HILL RD
BROWNSBORO AL
35741-9221
US

IV. Provider business mailing address

1030 DUG HILL RD
BROWNSBORO AL
35741-9221
US

V. Phone/Fax

Practice location:
  • Phone: 256-527-8169
  • Fax:
Mailing address:
  • Phone: 256-527-8169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13315
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: