Shannon, Charles A.

Shannon, Charles A. is an individual health care provider with primary practice located at 711 N Union Ave , Roswell NM 88201-3955. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Shannon, Charles A. can be contacted via phone (505) 622-6571.

Contact Information

Primary practice address
711 N Union Ave Roswell NM 88201-3955
Phone: (505) 622-6571
Fax: (505) 623-3801
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 3851 New Mexico

Profile Details

NPI number 1093701435
LBN Legal business name Shannon, Charles A.
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093701435 NPPES
New Mexico Other 3851 NM PHARACIST ID NUMBER

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