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General NPI Number Information
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NPI Number | 1770064107
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Entity Type | Individual
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Provider Name | EDWARD JUDE STEIN PHARMD, MPH
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Gender | Male
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | TWO RENAISSANCE SQUARE, 40 N CENTRAL AVE SUITE 780, IHS CLINICAL SUPPORT CENTER
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City | PHOENIX
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State | AZ
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Zip | 85004
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Country | US
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Telephone | 602-364-7777
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Fax | 602-364-7788
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Provider Business Mailing Address
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Address Line | 12929 N 72ND AVE
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City | PEORIA
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State | AZ
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Zip | 85381-9583
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Country | US
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Telephone | 623-910-1074
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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 | 10663
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License Number State | NE
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