Provider Demographics
NPI:1942291687
Name:STANFORD, STACY Y (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:Y
Last Name:STANFORD
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 1:400 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5441
Mailing Address - Country:US
Mailing Address - Phone:785-452-7160
Mailing Address - Fax:785-452-6945
Practice Address - Street 1:400 S SANTA FE AVE
Practice Address - Street 2:SALINA REGIONAL HEALTH CENTER PHARMACY
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4144
Practice Address - Country:US
Practice Address - Phone:785-452-7160
Practice Address - Fax:785-452-7136
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist