Provider Demographics
NPI:1841593688
Name:CERTO, STEPHEN P (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:P
Last Name:CERTO
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 1:1 GEOFFREY ROAD
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-4317
Mailing Address - Country:US
Mailing Address - Phone:856-404-8836
Mailing Address - Fax:
Practice Address - Street 1:1745 EASTON ROAD
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-428-5962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist