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General NPI Number Information
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NPI Number | 1861915100
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Entity Type | Individual
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Provider Name | GLORIA FRANKENFELD STACY
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 540 W. JAMESTOWN AVENUE
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City | TIFFIN
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State | OH
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Zip | 44883-4488
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Country | US
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Telephone | 419-934-3023
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Fax | 419-934-3023
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Provider Business Mailing Address
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Address Line | 540 W JAMESTOWN AVE
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City | TIFFIN
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State | OH
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Zip | 44883-3464
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Country | US
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Telephone | 419-934-3023
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 03114995
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03114995
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License Number State | OH
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