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General NPI Number Information
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NPI Number | 1245552868
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Entity Type | Individual
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Provider Name | KENNETH STERLING SHIPLEY PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 02/23/2010
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 300 W MARIPOSA RD
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City | NOGALES
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State | AZ
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Zip | 85621-1043
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Country | US
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Telephone | 520-761-4223
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Fax | 520-761-1911
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Provider Business Mailing Address
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Address Line | 300 W MARIPOSA RD
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City | NOGALES
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State | AZ
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Zip | 85621-1043
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Country | US
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Telephone | 520-761-4223
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Fax | 520-761-1911
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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 | S014578
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License Number State | AZ
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