Provider Demographics
NPI:1447567243
Name:DAVIS, STEPHANIE E (RPH)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LONGACRE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3811
Mailing Address - Country:US
Mailing Address - Phone:610-831-8930
Mailing Address - Fax:
Practice Address - Street 1:16 LONGACRE DR
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3811
Practice Address - Country:US
Practice Address - Phone:610-831-8930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042543L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist