Provider Demographics
NPI:1750391538
Name:HELLERICK, STEPHANIE (RPH)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:HELLERICK
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 1:4159 HUCKLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8502
Mailing Address - Country:US
Mailing Address - Phone:610-351-4094
Mailing Address - Fax:
Practice Address - Street 1:3110 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3630
Practice Address - Country:US
Practice Address - Phone:610-776-4357
Practice Address - Fax:610-776-4407
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035474L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP035474LOtherPHARMACY LICENSE
PARP035474LOtherPHARMACY LICENSE