Provider Demographics
NPI:1467534867
Name:STONE, STEPHANIE G (RPH)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:G
Last Name:STONE
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 1:25451 ROAD T.5
Mailing Address - Street 2:
Mailing Address - City:DOLORES
Mailing Address - State:CO
Mailing Address - Zip Code:81323-9208
Mailing Address - Country:US
Mailing Address - Phone:970-882-8084
Mailing Address - Fax:
Practice Address - Street 1:RUSTLING WILLOW COMPLEX D
Practice Address - Street 2:
Practice Address - City:TOWAOC
Practice Address - State:CO
Practice Address - Zip Code:81334-9999
Practice Address - Country:US
Practice Address - Phone:970-565-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist