Organization
SHELTON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SHELTON (PRESIDENT)
(937) 253-4108
Entity
Organization
Contact information
Practice address
1525 WAYNE AVE, DAYTON, OH 45410-1707
(937) 253-4108
(937) 253-8662
Mailing address
1525 WAYNE AVE, DAYTON, OH 45410-1707
(937) 253-4108
(937) 253-8662
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
OH
333600000X
Pharmacy
—
OH
3336C0003X
Community/Retail Pharmacy
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3604041
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8017916
—
OH
Enumeration date
08/31/2006
Last updated
12/12/2007
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