Provider Demographics
NPI:1316222599
Name:SHOEMAKER, PAUL E (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:E
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 WALDON DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-8271
Mailing Address - Country:US
Mailing Address - Phone:317-883-2866
Mailing Address - Fax:
Practice Address - Street 1:700 US HIGHWAY 31 S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-2401
Practice Address - Country:US
Practice Address - Phone:317-883-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018674A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist