Healthcare Provider Details

I. General information

NPI: 1972149763
Provider Name (Legal Business Name): STEPHEN P ERNEST PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4714 S US HIGHWAY 41
TERRE HAUTE IN
47802-4413
US

IV. Provider business mailing address

4714 S US HIGHWAY 41
TERRE HAUTE IN
47802-4413
US

V. Phone/Fax

Practice location:
  • Phone: 812-232-8379
  • Fax: 812-232-8472
Mailing address:
  • Phone: 812-232-8379
  • Fax: 812-232-8472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26017876A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: