Healthcare Provider Details

I. General information

NPI: 1851203319
Provider Name (Legal Business Name): JEREMY STEHLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 E BASELINE RD STE 101
GILBERT AZ
85234-2736
US

IV. Provider business mailing address

4001 E BASELINE RD STE 101
GILBERT AZ
85234-2736
US

V. Phone/Fax

Practice location:
  • Phone: 480-590-4237
  • Fax: 480-597-7498
Mailing address:
  • Phone: 480-590-4237
  • Fax: 480-597-7498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024038
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: