MEDICARE: STEVEN MAIERS

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	RP042334L	PA

General Provider Information

NPI Number	:	1841887775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN MAIERS

Provider Business Mailing Address
First Line	:	150 BANTRY ST
Second Line	:
City	:	SWEDESBORO
State	:	NJ
Zip	:	08085-3188
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2804
Country	:	US
Telephone Number	:	610-872-5418
Fax Number	:

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

Provider Enumeration Date	:	12/27/2020
Last Update Date	:	12/27/2020

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