SHENOAH M SHANNON (NPI# 1215150354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215150354 |
| Entity Type | Individual |
| Full Name | SHENOAH M SHANNON |
| Practice Address |
1720 S Broad St Philadelphia PA 19145-2315 |
| Mailing Address |
500 S Broad St Philadelphia PA 19146-1613 |
| Practice Telephone | 2156851834 |
| Mailing Telephone | 2156856864 |
| Mailing Fax Number | 2157901651 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | Pharmacy Service Providers |
| Street Address |
1720 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19145-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841202140 | Efren Costibolo Go | Pediatrics | 1720 S Broad St, Health Care Center #2, Philadelphia, PA 19145-2315 | 2006-08-13 |
| 1396870275 | Barbara J Capezio | Nurse Practitioner | 1720 S Broad St, Health Care Center 2, Philadelphia, PA 19145-2315 | 2007-02-22 |
| 1851497994 | Sandra Robinson | Pharmacy Technician | 1720 S Broad St, Philadelphia, PA 19145-2315 | 2006-09-16 |
| 1962508010 | Phaedra Kirkland | Pharmacist | 1720 S Broad St, Philadelphia, PA 19145-2315 | 2006-09-16 |
| 1124136346 | Susan Wenger Robbins | Pediatrics | 1720 S Broad St, Health Care Center #2, Philadelphia, PA 19145-2315 | 2006-08-28 |
| 1780790832 | Nicholas Nghi Vo | Dentist | 1720 S Broad St, Health Center #2, Philadelphia, PA 19145-2315 | 2006-08-22 |
| 1306959309 | Julie Sosa Cherian | Internal Medicine | 1720 S Broad St, Health Care Center #2, Philadelphia, PA 19145-2315 | 2006-08-16 |
| 1710990239 | Nino Vittorio | Internal Medicine | 1720 S Broad St, Health Care Center #2, Philadelphia, PA 19145-2315 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564350 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2300a Rear W Oregon Ave, Philadelphia, PA 19145 | 2020-10-05 |
| 1376069559 | Kyle James Hughes | Physical Therapist | 2192 W Oregon Ave Fl 3, Philadelphia, PA 19145 | 2017-08-18 |
| 1821519752 | John A Takacs Dmd | Clinic/Center | 1707w Passyunk Ave, Philadelphia, PA 19145 | 2017-06-30 |
| 1033573209 | Kenneth Donahue | Dentist | 1517 Packer Avenue, Philadelphia, PA 19145 | 2016-04-13 |
| 1437516895 | Kimberly Wyand | Physical Therapist | 2129 Oregon St, Philadelphia, PA 19145 | 2016-01-15 |
| 1760856538 | Liji Vipin | Nurse Practitioner | 1615 Oregon Ave, Philadelphia, PA 19145 | 2015-11-17 |
| 1528333846 | Gina Marie Doyle | Registered Nurse | 1930 S. Broad Street, Philadelphia, PA 19145 | 2012-03-20 |
| 1639446214 | Thao T Tran | Pharmacist | 2014-24 South Broad St, Philadelphia, PA 19145 | 2011-11-25 |
| 1649573171 | Phyllis Yang | Internal Medicine | 1700 S Broad St, Unit 201, Philadelphia, PA 19145 | 2010-12-05 |
| 1326364613 | South Philadelphia Open Mri, LLC | Clinic/Center | 1834 West Oregon Avenue, Philadelphia, PA 19145 | 2010-04-13 |
| Find all providers in zip 19145 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285126862 | Kisha Monique Blackmon | Pharmacy Technician | 5730 Woodcrest Ave, Philadelphia, PA 19131-2225 | 2018-05-31 |
| 1487044020 | Stefanie Black | Pharmacy Technician | 2527 Target Pharmacy, Philadelphia, PA 19150 | 2015-02-04 |
| 1003206590 | Fatima Jackson | Pharmacy Technician | 2527 Shoppers Lane, Cheltenham Square Mall, Philadelphia, PA 19150 | 2015-02-04 |
| 1154711851 | Christina Vanburen | Pharmacy Technician | 712 Landis St, Philadelphia, PA 19124-3011 | 2015-02-02 |
| 1023408838 | Elona Gjini | Pharmacy Technician | 470 Gerhard St, Philadelphia, PA 19128-3457 | 2015-02-01 |
| 1720322670 | Tieraney Simmons | Pharmacy Technician | 4417 Richmond St, Philadelphia, PA 19137-2026 | 2012-11-15 |
| 1992096051 | Rath Sun | Pharmacy Technician | 2843 Bittern Place, Philadelphia, PA 19142 | 2011-04-25 |
| 1407073307 | Aisha Dark | Pharmacy Technician | 6008 W Thompson St, Philadelphia, PA 19151-4436 | 2007-04-20 |
| 1265657118 | Betty Beckham | Pharmacy Technician | 1949 N 32nd St, Apt. B, Philadelphia, PA 19121-1705 | 2007-04-16 |
| 1124418868 | Angela Joy Luczejko | Pharmacy Technician | 1 Mifflin St, Philadelphia, PA 19148-2017 | 2015-02-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19145 |
Please comment or provide details below to improve the information on SHENOAH M SHANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.