Provider Demographics
NPI:1144659277
Name:STEELE, SHANNON ELIZABETH (RPH)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:ELIZABETH
Last Name:STEELE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8047 US ROUTE 127
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45311-9501
Mailing Address - Country:US
Mailing Address - Phone:937-452-7375
Mailing Address - Fax:
Practice Address - Street 1:8047 US RTE 127
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45311
Practice Address - Country:US
Practice Address - Phone:937-452-7375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-18314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist