Provider Demographics
NPI:1851838874
Name:PARKER, STEVE (RPH)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:PARKER
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 1:539 S FAWNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-7540
Mailing Address - Country:US
Mailing Address - Phone:316-641-9299
Mailing Address - Fax:
Practice Address - Street 1:539 S FAWNWOOD CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235-7540
Practice Address - Country:US
Practice Address - Phone:316-641-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-28
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-10988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist