Shelbina Pharmacy L L C

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2015016416 Issued in MO

Legal business name

SHELBINA PHARMACY L L C

Doing business as

Shelbina Pharmacy LLC

Practice address

201 N Center St
Ste a
Shelbina, MO 63468-1117

Phone

(573) 588-2143

Fax

(573) 588-7545

NPI assigned

Aug 13, 2009

Organization subpart

No

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

Authorized official

Name

Jonathan Patrick Earley

Title

Owner/Pic

Phone

(573) 588-2143

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shelbina Pharmacy LLC Doing business as

Locations

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1568694297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CENTER ST",
            "address_2": "STE A",
            "city": "SHELBINA",
            "state": "MO",
            "postal_code": "634681117",
            "telephone_number": "573-588-2143",
            "fax_number": "573-588-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CENTER ST",
            "address_2": "STE A",
            "city": "SHELBINA",
            "state": "MO",
            "postal_code": "634681117",
            "telephone_number": "573-588-2143",
            "fax_number": "573-588-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBINA PHARMACY L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "EARLEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "573-588-2143"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2015016416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121570",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelbina Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelbina Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David F. Ouellette, M.D.
• Barbara B Russell, DDS
• Wesley A Russell II, DDS
• Kelly M Sadler, PT, DPT
• Salt River Nursing Home District (Salt River Community Care)
• Shelbina Village Estates, Inc
• Shelby County R-IV Schools
• Shelby County Senior Citizens Assocation Inc
• Shelby County Senior Citizens Association Inc.
• Spectrum Partners L.L.C. (Shelbina Villa Lifecare)

• Community/Retail Pharmacy in Shelbina, MO
• Providers in Shelbina, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.