Provider Demographics
NPI:1306987748
Name:STELTZ, BRIAN E (RPH)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:STELTZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 REYNARD RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3521
Mailing Address - Country:US
Mailing Address - Phone:610-337-1730
Mailing Address - Fax:
Practice Address - Street 1:23 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-578-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10003014183500000X
NJ28RI02654200183500000X
PARP040820L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist