Provider Demographics
NPI:1588834105
Name:SHELDON'S EXPRESS PHARMACY INC.
Entity Type:Organization
Organization Name:SHELDON'S EXPRESS PHARMACY INC.
Other - Org Name:EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:270-392-0822
Mailing Address - Street 1:843 FAIRVIEW AVE STE B-6
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4914
Mailing Address - Country:US
Mailing Address - Phone:270-842-7254
Mailing Address - Fax:270-842-7254
Practice Address - Street 1:843 FAIRVIEW AVENUE SUITE B-6
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4914
Practice Address - Country:US
Practice Address - Phone:270-842-7254
Practice Address - Fax:270-842-7254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP072433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy