Shelby Alexis Fairchild
Individual provider Active NPI Pharmacist · Grayson, KY
NPI 1750159117 · NPPES record last updated Dec 15, 2023
Key facts
- NPI
- 1750159117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 024002 (KY)
- Practice address
- 100 S Carol Malone Blvd
Grayson, KY 41143-1352 - Phone
- (606) 474-4470
- NPI assigned
- Dec 15, 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 |
|---|---|---|---|
| 024002 | KY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 024002 | KY | Yes |
Addresses
Primary practice location
100 S Carol Malone Blvd
Grayson, KY 41143-1352
Mailing address
100 S Carol Malone Blvd
Grayson, KY 41143-1352
Phone (606) 474-4470
Other providers in Grayson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 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.