MEDICARE: CAROL H SHIPLET

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	9440	MD

General Provider Information

NPI Number	:	1760071500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL H SHIPLET

Provider Business Mailing Address
First Line	:	4832 BRISCOE RD
Second Line	:
City	:	SAINT LEONARD
State	:	MD
Zip	:	20685-2005
Country	:	US
Telephone Number	:	443-532-1729
Fax Number	:

Provider Business Practice Location Address
First Line	:	4832 BRISCOE RD
Second Line	:
City	:	SAINT LEONARD
State	:	MD
Zip	:	20685-2005
Country	:	US
Telephone Number	:	443-532-1729
Fax Number	:

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

Provider Enumeration Date	:	01/15/2021
Last Update Date	:	01/15/2021

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Directions to “ CAROL H SHIPLET ” Practice Location

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