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Individual

MR. CARL E SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
296 CHURCH ST, PETROLIA, PA 16050-0354
(724) 756-4050
(724) 756-4060
Mailing address
296 CHURCH ST, PO BOX 354, PETROLIA, PA 16050-0354
(724) 756-4050
(724) 756-4060

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP038470L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RP038470L
PA STATE PHARMACY LICENSE
PA
Enumeration date
08/16/2005
Last updated
01/24/2012
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