Provider Demographics
NPI:1437736436
Name:SPILLIARDS, STEVE (RPH)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:SPILLIARDS
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 1:109 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-7020
Mailing Address - Country:US
Mailing Address - Phone:912-659-2771
Mailing Address - Fax:
Practice Address - Street 1:911 E 65TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4412
Practice Address - Country:US
Practice Address - Phone:912-355-0122
Practice Address - Fax:912-355-6620
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA013356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist