Provider Demographics
NPI:1265807077
Name:KARBACKA, SHELBY (PHARMD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:KARBACKA
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 1:5533 RIDGEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-4618
Mailing Address - Country:US
Mailing Address - Phone:440-344-6378
Mailing Address - Fax:
Practice Address - Street 1:240 MARKET SQUARE DR
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2886
Practice Address - Country:US
Practice Address - Phone:440-324-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist