Healthcare Provider Details

I. General information

NPI: 1174857981
Provider Name (Legal Business Name): MARLANA MARIE STEPHAN R.PH., PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2009
Last Update Date: 09/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CLAY PIKE
N. HUNTINGDON PA
15642
US

IV. Provider business mailing address

10 CLAY PIKE
N. HUNTINGDON PA
15642
US

V. Phone/Fax

Practice location:
  • Phone: 724-863-2350
  • Fax: 724-864-2259
Mailing address:
  • Phone: 724-863-2350
  • Fax: 724-864-2259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP439277
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: