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General NPI Number Information
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NPI Number | 1689767725
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Entity Type | Individual
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Provider Name | ANTHONY WAYNE SHURTS R.PH.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 367 BOLETUS CREEK DR
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City | BAYFIELD
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State | CO
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Zip | 81122-9733
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Country | US
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Telephone | 970-769-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 367 BOLETUS CREEK DR
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City | BAYFIELD
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State | CO
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Zip | 81122-9733
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Country | US
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Telephone | 970-884-1902
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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 | 03-2-11205
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA-15463
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License Number State | CO
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