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General NPI Number Information
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NPI Number | 1124756119
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Entity Type | Individual
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Provider Name | STEPHEN VICKERY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 705 6TH AVE W STE D
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4161
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Country | US
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Telephone | 828-694-8422
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Fax | 828-694-8423
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Provider Business Mailing Address
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Address Line | 11 SQUIRREL TRL
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-8200
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Country | US
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Telephone | 410-980-1346
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22682
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 700405
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License Number State | NC
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