Provider Demographics
NPI:1306981089
Name:HOPPER, SHAWN A (RPH)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:A
Last Name:HOPPER
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 1:509 GARLAND DR
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4449
Mailing Address - Country:US
Mailing Address - Phone:717-609-3039
Mailing Address - Fax:
Practice Address - Street 1:509 GARLAND DR
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4449
Practice Address - Country:US
Practice Address - Phone:717-609-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14993183500000X
PARP438362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP438362OtherLICENSE #
MD14993OtherLICENSE#
184110OtherNABP