Provider Demographics
NPI:1033221437
Name:SHRIVERS DRUG COMPANY
Entity type:Organization
Organization Name:SHRIVERS DRUG COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:SHRIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-962-2552
Mailing Address - Street 1:3949 N POINTE DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-7361
Mailing Address - Country:US
Mailing Address - Phone:740-455-5555
Mailing Address - Fax:740-455-2322
Practice Address - Street 1:3949 N POINTE DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7361
Practice Address - Country:US
Practice Address - Phone:740-455-5555
Practice Address - Fax:740-455-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty