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General NPI Number Information
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NPI Number | 1356960355
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Entity Type | Individual
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Provider Name | MICHAEL JAMES SHELLEY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 2091 EASTWOOD AVE
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City | AKRON
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State | OH
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Zip | 44305-1966
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Country | US
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Telephone | 330-630-9066
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Fax | 330-630-2861
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Provider Business Mailing Address
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Address Line | 445 ROSEDALE ST
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City | RAVENNA
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State | OH
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Zip | 44266-3450
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Country | US
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Telephone | 419-217-9347
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Fax |
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 03136107
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License Number State | OH
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