Provider Demographics
NPI:1912506270
Name:STONE, TYLER (PHARMD, CPP)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:STONE
Suffix:
Gender:M
Credentials:PHARMD, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 BROCKTON LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3598
Mailing Address - Country:US
Mailing Address - Phone:785-893-2505
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD 7TH FLOOR JANEWAY TOWER
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7002641835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist