Provider Demographics
NPI:1972714848
Name:BIRCH, STEPHEN CHARLES
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:CHARLES
Last Name:BIRCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 ELK RUN RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3542
Mailing Address - Country:US
Mailing Address - Phone:603-886-1041
Mailing Address - Fax:
Practice Address - Street 1:213 DANIEL WEBSTER HWY
Practice Address - Street 2:SHAWS PHARMACY
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-6600
Practice Address - Country:US
Practice Address - Phone:603-888-0061
Practice Address - Fax:603-888-1834
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist