Organization
SHELBINA PHARMACY L L C
Active
Other names
Shelbina Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN PATRICK EARLEY (OWNER/PIC)
(573) 588-2143
Entity
Organization
Contact information
Practice address
201 N CENTER ST, STE A, SHELBINA, MO 63468-1117
(573) 588-2143
(573) 588-7545
Mailing address
201 N CENTER ST, STE A, SHELBINA, MO 63468-1117
(573) 588-2143
(573) 588-7545
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2015016416
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121570
PK
—
Enumeration date
08/13/2009
Last updated
08/14/2019
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