Provider Demographics
NPI:1215369731
Name:SHILLINGBURG, ALEXANDRA SHEA (PHARMD, BCOP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:SHEA
Last Name:SHILLINGBURG
Suffix:
Gender:F
Credentials:PHARMD, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MOREHEAD MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2990
Mailing Address - Country:US
Mailing Address - Phone:980-442-2000
Mailing Address - Fax:
Practice Address - Street 1:1021 MOREHEAD MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2990
Practice Address - Country:US
Practice Address - Phone:980-442-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP00076871835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1835X0200XPharmacy Service ProvidersPharmacistOncology