MEDICARE: STEPHEN CORNWELL R.PH.

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	1835P2201X	Ambulatory Care Pharmacist	RP0005103	WV

General Provider Information

NPI Number	:	1700729381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN CORNWELL R.PH.

Provider Business Mailing Address
First Line	:	97604 FRANKLIN RDG
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-8357
Country	:	US
Telephone Number	:	928-797-1066
Fax Number	:

Provider Business Practice Location Address
First Line	:	97604 FRANKLIN RDG
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-8357
Country	:	US
Telephone Number	:	928-797-1066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ STEPHEN CORNWELL R.PH.” Practice Location

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