Healthcare Provider Details

I. General information

NPI: 1023908456
Provider Name (Legal Business Name): SHANNON HABBA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8374 W FRANKLIN ST
MOUNT PLEASANT NC
28124-8812
US

IV. Provider business mailing address

49513 W CENTRAL PARK
SHELBY TOWNSHIP MI
48317-6354
US

V. Phone/Fax

Practice location:
  • Phone: 704-436-9613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33921
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: