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NPI 1508856444

NPI 1508856444 : FAYE L. STAHL R. PH. : VERMILION, OH

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General NPI Number Information
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    NPI Number           |    1508856444
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    Entity Type          |    Individual 
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    Provider Name        |    FAYE L. STAHL R. PH.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/24/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5267 PORTAGE DR 
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    City                 |    VERMILION
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    State                |    OH
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    Zip                  |    44089-1429
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    Country              |    US
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    Telephone            |    440-967-4832
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    Fax                  |    440-967-1919
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Provider Business Mailing Address
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    Address Line         |    5267 PORTAGE DR 
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    City                 |    VERMILION
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    State                |    OH
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    Zip                  |    44089-1429
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    Country              |    US
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    Telephone            |    440-967-4832
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    Fax                  |    440-967-1919
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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       |    03-1-07127
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    License Number State |    OH
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