MEDICARE: DR. STEPHANIE KIERCE SCEALS DOCTOR OF PHARMACY

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	RPH022307	GA

General Provider Information

NPI Number	:	1730251158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE KIERCE SCEALS DOCTOR OF PHARMACY

Provider Business Mailing Address
First Line	:	2516 PHEASANT DR
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-3021
Country	:	US
Telephone Number	:	229-446-4575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 DAWSON RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-3853
Country	:	US
Telephone Number	:	229-436-1518
Fax Number	:

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/08/2007

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