MEDICARE: MR. SCOTT THOMAS STELTZ 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
1	183500000X	Pharmacist	A10002884	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RP036896L	OTHER	PA	PHARMACIST LICENSE NUMBER
2	28RI02143600	OTHER	NJ	PHARMACY LICENSE
3	A10002884	OTHER	DE	PROFESSIONAL LICENSE

General Provider Information

NPI Number	:	1538205463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT THOMAS STELTZ R PH

Provider Business Mailing Address
First Line	:	444 S NEW MIDDLETOWN RD
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-5438
Country	:	US
Telephone Number	:	484-448-2201
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 UPLAND AVE SUITE 112
Second Line	:	STELTEC PHARMACY - CROZIER MILLS ENTERPRISE CENTER
City	:	UPLAND
State	:	PA
Zip	:	19015
Country	:	US
Telephone Number	:	888-837-4276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	05/19/2008

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