Shively, Larry Wayne

Shively, Larry Wayne is an individual health care provider with primary practice located at 5Th And Roosevelt 119, Hines IL 60141. He recently has only one registered license in Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, which is considered as his primary health care specialty. Shively, Larry Wayne can be contacted via phone (708) 202-8387.

Contact Information

Primary practice address
5Th And Roosevelt 119 Hines IL 60141
Phone: (708) 202-8387
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 040875 Missouri

Profile Details

NPI number 1124116355
LBN Legal business name Shively, Larry Wayne
Credentials BS PHARMACY
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Feb 1st, 2024 - about 10 months 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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