Provider Demographics
NPI:1467905349
Name:BELLOWS, STEPHANIE WHITE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:WHITE
Last Name:BELLOWS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2676
Mailing Address - Country:US
Mailing Address - Phone:904-707-4838
Mailing Address - Fax:910-671-9056
Practice Address - Street 1:4307 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2676
Practice Address - Country:US
Practice Address - Phone:984-218-2063
Practice Address - Fax:910-671-9056
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029511183500000X
SC36737183500000X
ARPD140291835P2201X
NC278061835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist