Healthcare Provider Details

I. General information

NPI: 1770733982
Provider Name (Legal Business Name): JEANETTE D. SHREWSBURY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 SCARBRO ROAD
SCARBRO WV
25917-0337
US

IV. Provider business mailing address

908 SCARBRO RD PO BOX 337
SCARBRO WV
25917-8837
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-3424
  • Fax: 304-929-6776
Mailing address:
  • Phone: 304-469-3424
  • Fax: 304-929-6776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0006571
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: