Healthcare Provider Details

I. General information

NPI: 1396194296
Provider Name (Legal Business Name): STEPHANIE STAMOS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 07/05/2021
Certification Date: 07/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WATER ST
CHARDON OH
44024-1146
US

IV. Provider business mailing address

501 WATER ST
CHARDON OH
44024-1146
US

V. Phone/Fax

Practice location:
  • Phone: 440-286-4167
  • Fax:
Mailing address:
  • Phone: 440-286-4167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03233276
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: