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NPI Code Detail

MEDICARE: DR. STEPHEN ANDERSON PHARMD

MEDICARE:  DR. STEPHEN  ANDERSON  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202209953VA

General Provider Information

NPI Number : 1154948438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN ANDERSON PHARMD
Provider Business Mailing Address
First Line : 4121 HALIFAX RD
Second Line :
City : SOUTH BOSTON
State : VA
Zip : 24592-4833
Country : US
Telephone Number : 434-575-0511
Fax Number : 434-575-1366
Provider Business Practice Location Address
First Line : 4121 HALIFAX RD
Second Line :
City : SOUTH BOSTON
State : VA
Zip : 24592-4833
Country : US
Telephone Number : 434-575-0511
Fax Number : 434-575-1366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2020
Last Update Date : 07/02/2020

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Directions to “ DR. STEPHEN ANDERSON PHARMD” Practice Location

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