Provider Demographics
NPI:1700834678
Name:STEWARD, MARGARET GRACE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:GRACE
Last Name:STEWARD
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 1:1641 S SHADY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683-2015
Mailing Address - Country:US
Mailing Address - Phone:423-727-0039
Mailing Address - Fax:423-727-0098
Practice Address - Street 1:1641 SOUTH SHADY ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683
Practice Address - Country:US
Practice Address - Phone:423-727-0039
Practice Address - Fax:423-727-0098
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3624183500000X
NC14273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist