Provider Demographics
NPI:1033113923
Name:SHELL, AMI TEAGUE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMI
Middle Name:TEAGUE
Last Name:SHELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MALAGA AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2026
Mailing Address - Country:US
Mailing Address - Phone:205-871-8198
Mailing Address - Fax:
Practice Address - Street 1:800 LAKESHORE DR
Practice Address - Street 2:MCWHORTER SCHOOL OF PHARMACY
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35229-0001
Practice Address - Country:US
Practice Address - Phone:205-726-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist