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NPI Code Detail

MEDICARE: PENNY STEWART R.PH.

MEDICARE: PENNY STEWART R.PH.
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
11835P1200XPharmacotherapy Pharmacist8999NC

General Provider Information

NPI Number : 1467452730
Entity Type Code : Individual
Provider Name (Legal Business Name) : PENNY STEWART R.PH.
Provider Business Mailing Address
First Line : 7437 RUBEN LINKER RD NW
Second Line :
City : CONCORD
State : NC
Zip : 28027-3800
Country : US
Telephone Number : 704-614-2971
Fax Number :
Provider Business Practice Location Address
First Line : 1350 S KINGS DR
Second Line : CMC MYERS PARK PHARMACY SUITE 101
City : CHARLOTTE
State : NC
Zip : 28207-2134
Country : US
Telephone Number : 704-446-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 07/08/2007

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Directions to “ PENNY STEWART R.PH.” Practice Location

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