Provider Demographics
NPI:1134502362
Name:SHELLEY, ERIC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SHELLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 OAK CREEK PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5248
Mailing Address - Country:US
Mailing Address - Phone:501-626-8788
Mailing Address - Fax:501-455-0500
Practice Address - Street 1:10320 STAGECOACH RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-4751
Practice Address - Country:US
Practice Address - Phone:501-455-1900
Practice Address - Fax:501-455-0500
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist