MEDICARE: STELTEC PHARMACY 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	3336I0012X	Institutional Pharmacy
2	3336L0003X	Long Term Care Pharmacy	PP481827	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3990656	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1669639506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELTEC PHARMACY INC

Provider Business Mailing Address
First Line	:	601 UPLAND AVE
Second Line	:	CROZER MILLS ENTERPRISE CENTER STE 112
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2434
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 UPLAND AVE
Second Line	:	STE 112
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2434
Country	:	US
Telephone Number	:	888-837-4276
Fax Number	:

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	SCOTT STELTZ
Credential	:	RPH
Telephone Number	:	888-837-4276

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	08/13/2008

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Directions to “STELTEC PHARMACY INC ” Practice Location

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