Shelby Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

16737 Issued in SC

Legal business name

SHELBY PHARMACY LLC

Practice address

401 Hillcrest Dr
Easley, SC 29640-1221

Phone

(864) 642-4879

Fax

(864) 712-9279

NPI assigned

Aug 10, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerry Shelby, RPHNPI 1831497841

Title

Owner,Pic, Ao

Phone

(256) 503-5535

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Easley HealthMart Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Anthony Shelby III, PHARMD

  • Pharmacist
  • Anderson, SC
  • NPI 1831497841
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1528512357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 ARMISTEAD LN",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296428636",
            "telephone_number": "256-503-5535",
            "fax_number": "864-712-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HILLCREST DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296401221",
            "telephone_number": "864-642-4879",
            "fax_number": "864-712-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "SHELBY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER,PIC, AO",
        "authorized_official_telephone_number": "256-503-5535",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "16737",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162483",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716737",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easley HealthMart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ali Shames-Dawson, PHD
• Shaneca Wellness Retreat LLC Dba Sweet Louise Home Care
• Catherine Dewald Shaw, PA-C
• Danielle Sheffield, FNP-BC
• Shelby Pharmacy LLC
• Yaneve Shemesh, MD
• Louis Ervin Shepard, DDS
• Sheridan Emergency Physician Services of South Carolina, PA
• Julie K Shipe, PT
• David C Shorter, REV.

• Community/Retail Pharmacy in Easley, SC
• Providers in Easley, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.