Healthcare Provider Details

I. General information

NPI: 1306987748
Provider Name (Legal Business Name): BRIAN E. STELTZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 INDUSTRIAL BLVD
PAOLI PA
19301
US

IV. Provider business mailing address

8 REYNARD RD
MALVERN PA
19355-3521
US

V. Phone/Fax

Practice location:
  • Phone: 610-578-0411
  • Fax:
Mailing address:
  • Phone: 610-337-1730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA10003014
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02654200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP040820L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: