MEDICARE: STO-PHAR,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	50-002451	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053393710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STO-PHAR,INC

Provider Business Mailing Address
First Line	:	35 W LIBERTY ST
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-5240
Country	:	US
Telephone Number	:	803-773-7283
Fax Number	:	803-775-7908

Provider Business Practice Location Address
First Line	:	35 W LIBERTY ST
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-5240
Country	:	US
Telephone Number	:	803-773-7283
Fax Number	:	803-775-7908

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM LEWIS STOVER
Credential	:	R.PH.
Telephone Number	:	803-773-7283

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	08/22/2020

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Directions to “STO-PHAR,INC ” Practice Location

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