Provider Demographics
NPI:1033953062
Name:WARREN, SHELBY DANNIELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:DANNIELLE
Last Name:WARREN
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 1:4118 AMERICAN LEGION RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31001-5419
Mailing Address - Country:US
Mailing Address - Phone:229-425-8318
Mailing Address - Fax:
Practice Address - Street 1:1128 S PARK ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4450
Practice Address - Country:US
Practice Address - Phone:800-251-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist