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General NPI Number Information
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NPI Number | 1306353370
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Entity Type | Organization
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Legal Business Name | SHEPHERD PHARMACY INC
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 7191 66TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-4004
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Country | US
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Telephone | 727-967-6175
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Fax |
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Provider Business Mailing Address
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Address Line | 7191 66TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-4004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | GEORGE SHEHATA
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Credential |
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Telephone | 727-873-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH31104
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License Number State | FL
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