Individual
SHELLEY E MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 GRANT ST, GARY, IN 46404-3508
(219) 949-1055
Mailing address
1207 W 85TH CIR, MERRILLVILLE, IN 46410-7072
(219) 736-1862
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015435
IN
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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