Healthcare Provider Details

I. General information

NPI: 1124859152
Provider Name (Legal Business Name): SHELBY ELISE EFIRD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NORTH GREEN STREET
BALTIMORE MD
21201
US

IV. Provider business mailing address

520 PARK AVE APT 517
BALTIMORE MD
21201-4781
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29938
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33165
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: