Shane G Abbott, RPH
Individual provider Active NPI Pharmacist · Defuniak Springs, FL
NPI 1144336348 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144336348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS-33343 (FL)
- Practice address
- 1337 US Highway 90 W
Defuniak Springs, FL 32433-1470 - Phone
- (850) 892-6898
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS-33343 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prescription Place of Defuniak Springs Inc | Past | Accepting new patients | |
| Prescription Place of Defuniak Springs Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS-33343 | FL | Yes |
Addresses
Primary practice location
1337 US Highway 90 W
Defuniak Springs, FL 32433-1470
Mailing address
856 Ten Lake Dr
Defuniak Springs, FL 32433-4516
Phone (850) 859-9974
Other providers in Defuniak Springs, FL
All providers in Defuniak Springs, FL · Pharmacist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.