Provider Demographics
NPI:1356652523
Name:PHILLIPS, STEPHEN MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:PHILLIPS
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 1:524 WILLIAMSTOWN ROAD
Mailing Address - Street 2:ADLER'S PHARMACY
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081
Mailing Address - Country:US
Mailing Address - Phone:856-262-9564
Mailing Address - Fax:856-262-0299
Practice Address - Street 1:524 WILLIAMSTOWN ROAD
Practice Address - Street 2:ADLER'S PHARMACY
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081
Practice Address - Country:US
Practice Address - Phone:856-262-9564
Practice Address - Fax:856-262-0299
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01855700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist