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General NPI Number Information
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NPI Number | 1992171342
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Entity Type | Individual
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Provider Name | ANGELA KAY SHOULDERS PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 250 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1760
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Country | US
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Telephone | 270-745-1014
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Fax | 270-796-2500
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Provider Business Mailing Address
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Address Line | 1529 NEPTUNE WAY
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City | BOWLING GREEN
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State | KY
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Zip | 42104-0210
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Country | US
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Telephone | 270-991-4695
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Fax | 270-796-2500
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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 | 10461
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License Number State | KY
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