Provider Demographics
NPI:1750471835
Name:LADAS, STAVROS L (RPH)
Entity Type:Individual
Prefix:MR
First Name:STAVROS
Middle Name:L
Last Name:LADAS
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 1:426 S CRAFT HWY
Mailing Address - Street 2:
Mailing Address - City:CHICKASAW
Mailing Address - State:AL
Mailing Address - Zip Code:36611-2213
Mailing Address - Country:US
Mailing Address - Phone:251-456-4172
Mailing Address - Fax:251-456-4175
Practice Address - Street 1:426 S CRAFT HWY
Practice Address - Street 2:
Practice Address - City:CHICKASAW
Practice Address - State:AL
Practice Address - Zip Code:36611-2213
Practice Address - Country:US
Practice Address - Phone:251-456-4172
Practice Address - Fax:251-456-4175
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL106746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist