# SHELBY ONE CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104265115
- **Authorized official:** ANDREW STIVERS (PRESIDENT)
- **Authorized official phone:** (502) 229-1744

## Contact information

- **Practice address:** 30 MAIN ST, SHELBYVILLE, KY 40065-1020
- **Practice address phone:** (502) 229-1744
- **Mailing address:** 30 MAIN ST, SHELBYVILLE, KY 40065-1020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2013
- **Last updated:** 06/24/2013