MEDICARE: MR. WILLIAM R SHIRLEY RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	3552	SC

General Provider Information

NPI Number	:	1528231313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM R SHIRLEY RPH

Provider Business Mailing Address
First Line	:	309 VIRGINIA ST
Second Line	:
City	:	JOHNSTON
State	:	SC
Zip	:	29832-1338
Country	:	US
Telephone Number	:	803-275-4524
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 E MARTINTOWN RD
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-4261
Country	:	US
Telephone Number	:	803-278-3673
Fax Number	:	803-442-3824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	04/11/2008

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