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General NPI Number Information
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NPI Number | 1639112998
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Entity Type | Organization
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Legal Business Name | SHELLYS MEDICATION SERVICES, INC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 2522 PEARL BUCK RD UNIT A
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City | BRISTOL
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State | PA
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Zip | 19007-6809
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Country | US
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Telephone | 218-785-6616
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Fax | 215-781-6020
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Provider Business Mailing Address
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Address Line | 2522 PEARL BUCK RD UNIT A
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City | BRISTOL
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State | PA
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Zip | 19007-6809
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Country | US
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Telephone | 218-785-6616
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Fax | 215-781-6020
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Authorized Official
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Title or Position | VP MARKETING
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Name | STANTON SPOON
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Credential | RPH BSC FASCP
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Telephone | 215-785-6616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PP414479L
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License Number State | PA
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