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General NPI Number Information
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NPI Number | 1578780854
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Entity Type | Individual
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Provider Name | MICHAEL STEIN PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 920 BROAD ST
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City | ELIZABETHTON
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State | TN
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Zip | 37643
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Country | US
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Telephone | 423-542-4925
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Fax |
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Provider Business Mailing Address
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Address Line | 238 PIERCETOWN RD
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City | BUTLER
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State | TN
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Zip | 37640-8000
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Country | US
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Telephone | 423-768-3897
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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 | 0000026092
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License Number State | TN
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