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NPI Code Detail

MEDICARE: SHELLY THOMPSON SHEFFIELD PHARMD

MEDICARE: SHELLY THOMPSON SHEFFIELD PHARMD
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
1183500000XPharmacistRPH025124GA

General Provider Information

NPI Number : 1679810790
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY THOMPSON SHEFFIELD PHARMD
Provider Business Mailing Address
First Line : 507 INDUSTRIAL BLVD
Second Line :
City : DUBLIN
State : GA
Zip : 31021-1714
Country : US
Telephone Number : 180-057-5316
Fax Number :
Provider Business Practice Location Address
First Line : 507 INDUSTRIAL BLVD
Second Line :
City : DUBLIN
State : GA
Zip : 31021-1714
Country : US
Telephone Number : 180-057-5316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2013
Last Update Date : 01/09/2013

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