Provider Demographics
NPI:1891281382
Name:STANLEY, WILLIAM D III (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:STANLEY
Suffix:III
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 1:1201 CENTRAL AVE APT 559
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2698
Mailing Address - Country:US
Mailing Address - Phone:704-989-0852
Mailing Address - Fax:
Practice Address - Street 1:2222 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-6581
Practice Address - Country:US
Practice Address - Phone:704-373-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-08
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist