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General NPI Number Information
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NPI Number | 1538481460
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Entity Type | Individual
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Provider Name | MR. STEPHEN THOMAS WORTHINGTON
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Gender | Male
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 803 MATRTIN ST S
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City | PELL CITY
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State | AL
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Zip | 35128
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Country | US
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Telephone | 205-884-2703
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Fax | 205-338-8388
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Provider Business Mailing Address
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Address Line | 25 MALLARD DR
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City | CROPWELL
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State | AL
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Zip | 35054-3825
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Country | US
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Telephone | 205-338-3607
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Fax | 205-338-8388
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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 | 10125
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License Number State | AL
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