Individual
EMILY MARIE SHOUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1010 E IRELAND RD, SOUTH BEND, IN 46614-2665
(574) 299-0154
(574) 299-2840
Mailing address
3630 FELLOWS ST, SOUTH BEND, IN 46614-1949
(574) 514-2379
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
26029648A
IN
390200000X
Student in an Organized Health Care Education/Training Program
45020507A
IN
390200000X
Student in an Organized Health Care Education/Training Program
5351012203
MI
Other
Enumeration date
08/25/2020
Last updated
05/25/2022
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