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Individual

THEODORE DARRYL SHUNK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
KROGER PHARMACY, 2034 S HWY 53, LAGRANGE, KY 40031
(502) 222-2028
(502) 222-5032
Mailing address
KROGER PHARMACY, 2034 S HWY 53, LAGRANGE, KY 40031
(502) 222-2028

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
010462
KY
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26026120A
IN

Other

Enumeration date
01/06/2020
Last updated
01/06/2020
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