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General NPI Number Information
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NPI Number | 1588767867
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Entity Type | Individual
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Provider Name | GUY W SHENEMAN DR. OF PHARMACY
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 311 WEST 9TH STREET
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City | WELEETKA
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State | OK
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Zip | 74880
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Country | US
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Telephone | 405-786-2246
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Fax | 405-786-2409
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Provider Business Mailing Address
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Address Line | PO BOX 758
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City | WELEETKA
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State | OK
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Zip | 74880-0758
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Country | US
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Telephone | 405-786-2150
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9806
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License Number State | OK
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