Provider Demographics
NPI:1255649638
Name:STAHL, JOHN ALLEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ALLEN
Last Name:STAHL
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 1:420 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27855-1419
Mailing Address - Country:US
Mailing Address - Phone:252-398-3585
Mailing Address - Fax:252-398-4711
Practice Address - Street 1:420 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:NC
Practice Address - Zip Code:27855-1419
Practice Address - Country:US
Practice Address - Phone:252-398-3585
Practice Address - Fax:252-398-4711
Is Sole Proprietor?:No
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016511183500000X
NC20784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist