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General NPI Number Information
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NPI Number | 1972776573
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Entity Type | Organization
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Legal Business Name | SHELBY DRUGSTORE, INC.
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Dates
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Enumeration Date | 04/04/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 701-1 EAST GROVER STREET
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City | SHELBY
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State | NC
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Zip | 28150
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Country | US
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Telephone | 704-487-2939
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Fax | 704-487-2811
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Provider Business Mailing Address
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Address Line | 701-1 EAST GROVER STREET
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City | SHELBY
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State | NC
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Zip | 28150
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Country | US
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Telephone | 704-487-2939
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Fax | 704-487-2811
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. MARK BROOKS
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Credential | RPH
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Telephone | 704-487-2939
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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 | 10044
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License Number State | NC
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