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NPI 1720187313

NPI 1720187313 : COLLEEN M SHELTON RPH : LOCKPORT, NY

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General NPI Number Information
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    NPI Number           |    1720187313
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    Entity Type          |    Individual 
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    Provider Name        |    COLLEEN M SHELTON RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/21/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    6606 LINCOLN AVE 
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    City                 |    LOCKPORT
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    State                |    NY
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    Zip                  |    14094-6109
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    Country              |    US
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    Telephone            |    716-438-3990
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    37 WHITNEY PL 
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    City                 |    CHEEKTOWAGA
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    State                |    NY
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    Zip                  |    14227-2550
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    Country              |    US
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    Telephone            |    716-668-8900
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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       |    041486
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    License Number State |    NY
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