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General NPI Number Information
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NPI Number | 1639697659
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Entity Type | Individual
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Provider Name | CANDACE STACY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | UNIVERSITY DRIVE (151C) BUILDING 29 RM M133
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City | PITTSBURGH
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State | PA
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Zip | 15240
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Country | US
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Telephone | 412-360-6625
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Fax |
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Provider Business Mailing Address
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Address Line | UNIVERSITY DRIVE C (151C) BUILDING 29 RM M133
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City | PITTSBURGH
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State | PA
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Zip | 15240
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Country | US
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Telephone | 412-360-6625
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 13730
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License Number State | AR
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