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General NPI Number Information
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NPI Number | 1134502362
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Entity Type | Individual
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Provider Name | ERIC SHELLEY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 10320 STAGECOACH RD
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City | LITTLE ROCK
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State | AR
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Zip | 72210-4751
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Country | US
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Telephone | 501-455-1900
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Fax | 501-455-0500
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Provider Business Mailing Address
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Address Line | 18000 OAK CREEK PL
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City | LITTLE ROCK
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State | AR
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Zip | 72223-5248
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Country | US
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Telephone | 501-626-8788
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Fax | 501-455-0500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD09896
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License Number State | AR
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