Provider Demographics
NPI:1235424367
Name:SLEDZIONA, STANLEY JOSEPH JR (RPH)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:JOSEPH
Last Name:SLEDZIONA
Suffix:JR
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 1:1703 ELM ST. W
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:SC
Mailing Address - Zip Code:29924
Mailing Address - Country:US
Mailing Address - Phone:803-943-0683
Mailing Address - Fax:803-943-0783
Practice Address - Street 1:1703 ELM ST. W
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924
Practice Address - Country:US
Practice Address - Phone:803-943-0683
Practice Address - Fax:803-943-0783
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist