Provider Demographics
NPI:1104021096
Name:DALEY, STEPHEN O (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:O
Last Name:DALEY
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 1:2131 DENISE DR NE
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-9454
Mailing Address - Country:US
Mailing Address - Phone:330-339-7675
Mailing Address - Fax:
Practice Address - Street 1:830 S 2ND ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1916
Practice Address - Country:US
Practice Address - Phone:740-622-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-12190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist