Provider Demographics
NPI:1770806937
Name:STANLEY, KEVIN F (RPH)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:F
Last Name:STANLEY
Suffix:
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 1:5432 GLENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-3915
Mailing Address - Country:US
Mailing Address - Phone:804-672-3570
Mailing Address - Fax:804-672-3380
Practice Address - Street 1:5432 GLENSIDE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-3915
Practice Address - Country:US
Practice Address - Phone:804-672-3570
Practice Address - Fax:804-672-3380
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist