Provider Demographics
NPI:1760785190
Name:SHELTON, ERICA B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:B
Last Name:SHELTON
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:MCGRAW AND MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271
Mailing Address - Country:US
Mailing Address - Phone:304-372-5292
Mailing Address - Fax:304-372-7668
Practice Address - Street 1:MCGRAW AND MAIN STREET
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271
Practice Address - Country:US
Practice Address - Phone:304-372-5292
Practice Address - Fax:304-372-7668
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist