Provider Demographics
NPI:1770183394
Name:FOSTER, STEPHANIE LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LEE
Last Name:FOSTER
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 1:1451 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:VA
Mailing Address - Zip Code:23824-2626
Mailing Address - Country:US
Mailing Address - Phone:434-292-4998
Mailing Address - Fax:434-292-1358
Practice Address - Street 1:1451 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLACKSTONE
Practice Address - State:VA
Practice Address - Zip Code:23824-2626
Practice Address - Country:US
Practice Address - Phone:434-292-4998
Practice Address - Fax:434-292-1358
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist