Provider Demographics
NPI:1568464345
Name:WELDON, STEPHEN LELUS (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:LELUS
Last Name:WELDON
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 1:1280 HUEYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-2602
Mailing Address - Country:US
Mailing Address - Phone:205-491-2805
Mailing Address - Fax:205-497-1432
Practice Address - Street 1:1280 HUEYTOWN RD
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-2602
Practice Address - Country:US
Practice Address - Phone:205-491-2805
Practice Address - Fax:205-497-1432
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist