Individual
MEGAN ROSE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
334 N MAYO TRL, KMART PHARMACY #4827, PAINTSVILLE, KY 41240-1804
(606) 789-3738
(606) 788-1407
Mailing address
334 N MAYO TRL, KMART PHARMACY #4827, PAINTSVILLE, KY 41240-1804
(606) 789-3738
(606) 788-1407
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011390
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011390
LICENSE NUMBER
KY
Enumeration date
08/25/2010
Last updated
08/25/2010
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