Healthcare Provider Details

I. General information

NPI: 1427524644
Provider Name (Legal Business Name): STEPHANIE ANNE FOLAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 OLENTANGY RIVER RD RM 4038
COLUMBUS OH
43212-3117
US

IV. Provider business mailing address

1145 OLENTANGY RIVER RD RM 4038
COLUMBUS OH
43212-3117
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-0191
  • Fax:
Mailing address:
  • Phone: 614-293-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number03438191
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: