Provider Demographics
NPI:1639697659
Name:STACY, CANDACE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:STACY
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:UNIVERSITY DRIVE C (151C)
Mailing Address - Street 2:BUILDING 29 RM M133
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-360-6625
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE (151C)
Practice Address - Street 2:BUILDING 29 RM M133
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-360-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR137301835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy