Provider Demographics
NPI:1043823065
Name:DROG, STEPHEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:DROG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 HAYWOOD ESTATE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3681
Mailing Address - Country:US
Mailing Address - Phone:815-978-0825
Mailing Address - Fax:
Practice Address - Street 1:8320 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-2147
Practice Address - Country:US
Practice Address - Phone:702-658-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist