Healthcare Provider Details

I. General information

NPI: 1598962862
Provider Name (Legal Business Name): MICHELLE M KUHAR-SHOPENE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 STATE ST HAMOT PHARMACY
ERIE PA
16550-0002
US

IV. Provider business mailing address

5121 LA RAE DR
ERIE PA
16506-5269
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-2483
  • Fax:
Mailing address:
  • Phone: 814-835-7488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP037503L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: