Provider Demographics
NPI:1952901910
Name:BLOCK, STEPHEN MARTIN (RPH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MARTIN
Last Name:BLOCK
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 1:29 FOXGLOVE DR
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3510
Mailing Address - Country:US
Mailing Address - Phone:401-742-0772
Mailing Address - Fax:
Practice Address - Street 1:1776 PLAINFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02921
Practice Address - Country:US
Practice Address - Phone:401-946-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH01689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist