Provider Demographics
NPI:1245391770
Name:GREGORY, STEPHANIE STALLINGS (RPH)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:STALLINGS
Last Name:GREGORY
Suffix:
Gender:F
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:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944
Mailing Address - Country:US
Mailing Address - Phone:252-426-2214
Mailing Address - Fax:252-426-3017
Practice Address - Street 1:606 SOUTH CHURCH ST
Practice Address - Street 2:
Practice Address - City:HERTFORD
Practice Address - State:NC
Practice Address - Zip Code:27944
Practice Address - Country:US
Practice Address - Phone:252-426-2214
Practice Address - Fax:252-426-3017
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0725028Medicaid