Provider Demographics
NPI:1326346248
Name:SHELBY, KATURA ANTOINETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATURA
Middle Name:ANTOINETTE
Last Name:SHELBY
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 1:106 HIGHWAY 28 BYP
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29624-3742
Mailing Address - Country:US
Mailing Address - Phone:864-296-5208
Mailing Address - Fax:864-296-5288
Practice Address - Street 1:106 HIGHWAY 28 BYP
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29624-3742
Practice Address - Country:US
Practice Address - Phone:864-296-5208
Practice Address - Fax:864-296-5288
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1366459323OtherWALGREENS PHARMACY