Provider Demographics
NPI:1689205296
Name:PIERCE, STEVEN JAMES (RPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:PIERCE
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 1:176 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-7535
Mailing Address - Country:US
Mailing Address - Phone:478-808-7576
Mailing Address - Fax:478-254-6092
Practice Address - Street 1:5928 ZEBULON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2097
Practice Address - Country:US
Practice Address - Phone:478-757-4152
Practice Address - Fax:478-757-9132
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA180221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist