Provider Demographics
NPI:1629626890
Name:KEHOE, SHELBY GRIFFIN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:GRIFFIN
Last Name:KEHOE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:LYNN
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:1491 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-4612
Mailing Address - Country:US
Mailing Address - Phone:727-736-2785
Mailing Address - Fax:
Practice Address - Street 1:1491 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-4612
Practice Address - Country:US
Practice Address - Phone:727-736-2785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist