Provider Demographics
NPI:1770785701
Name:LOUDON, SHANA ELISE (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHANA
Middle Name:ELISE
Last Name:LOUDON
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-9326
Mailing Address - Country:US
Mailing Address - Phone:315-730-8298
Mailing Address - Fax:
Practice Address - Street 1:4023 JORDAN RD
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-9326
Practice Address - Country:US
Practice Address - Phone:315-730-8298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY49008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist