MEDICARE: DR. SHELLEY RECORD PHARM.D.

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	2010032103	MO

General Provider Information

NPI Number	:	1609160787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLEY RECORD PHARM.D.

Provider Business Mailing Address
First Line	:	4375 N CHOUTEAU TRFY
Second Line	:	T-1388
City	:	KANSAS CITY
State	:	MO
Zip	:	64117-1743
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4375 N CHOUTEAU TRFY
Second Line	:	T-1388
City	:	KANSAS CITY
State	:	MO
Zip	:	64117-1743
Country	:	US
Telephone Number	:	816-452-8079
Fax Number	:

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

Provider Enumeration Date	:	06/06/2011
Last Update Date	:	06/07/2011

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Directions to “ DR. SHELLEY RECORD PHARM.D.” Practice Location

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