Healthcare Provider Details

I. General information

NPI: 1437436904
Provider Name (Legal Business Name): STEPHANIE L OHS PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13227 N 7TH ST
PHOENIX AZ
85022-5303
US

IV. Provider business mailing address

20425 N 7TH ST APT 1019
PHOENIX AZ
85024-6002
US

V. Phone/Fax

Practice location:
  • Phone: 406-939-0315
  • Fax:
Mailing address:
  • Phone: 406-939-0315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberSO18889
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: