Healthcare Provider Details

I. General information

NPI: 1992011522
Provider Name (Legal Business Name): STEPHEN M SLARSKY R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER AMC HI
96859-5001
US

IV. Provider business mailing address

1 JARRETT WHITE DRIVE TRIPLER ARMY MEDICAL CENTER
TRIPLER AMC HI
96859-5000
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-5240
  • Fax:
Mailing address:
  • Phone: 808-433-5240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16466
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: