Shelby Bedolla
Individual provider Active NPI Pharmacist · Pima, AZ
NPI 1699559773 · NPPES record last updated Aug 21, 2023
Key facts
- NPI
- 1699559773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S026589 (AZ)
- Practice address
- 18 W Center St
Pima, AZ 85543-0030 - Phone
- (928) 485-4315
- Fax
- (928) 485-4540
- NPI assigned
- Aug 21, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S026589 | AZ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S026589 | AZ | Yes |
Addresses
Primary practice location
18 W Center St
Pima, AZ 85543-0030
Mailing address
3956 W Pace St
Thatcher, AZ 85552-5266
Other providers in Pima, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2023. 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.