Provider Demographics
NPI:1043811235
Name:SHIPPER, MEGAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SHIPPER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1461 COUNTY ROAD 1575
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-9397
Mailing Address - Country:US
Mailing Address - Phone:419-564-0766
Mailing Address - Fax:
Practice Address - Street 1:359 N LEXINGTON SPRINGMILL RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-3808
Practice Address - Country:US
Practice Address - Phone:419-529-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03227907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist