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General NPI Number Information
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NPI Number | 1497350482
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Entity Type | Individual
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Provider Name | ALEXIS EBLING-STOUT RPH
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 1200 MARKET ST
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City | LEMOYNE
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State | PA
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Zip | 17043-1417
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Country | US
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Telephone | 717-761-1995
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Fax |
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Provider Business Mailing Address
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Address Line | 14 PENNY LN
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City | LEBANON
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State | PA
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Zip | 17046-9215
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Country | US
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Telephone | 717-644-3362
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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 | RP453605
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License Number State | PA
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