Healthcare Provider Details

I. General information

NPI: 1467905349
Provider Name (Legal Business Name): STEPHANIE WHITE BELLOWS PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 E BANNER GATEWAY DR
GILBERT AZ
85234-2165
US

IV. Provider business mailing address

2946 E BANNER GATEWAY DR
GILBERT AZ
85234-2165
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-5450
  • Fax: 480-256-5451
Mailing address:
  • Phone: 480-256-5450
  • Fax: 480-256-5451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH029511
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberS025843
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: