Provider Demographics
NPI:1316049521
Name:WOODS, STEPHEN TATE (PHARM D)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:TATE
Last Name:WOODS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 EDINBURGH ST
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-3641
Mailing Address - Country:US
Mailing Address - Phone:334-412-8076
Mailing Address - Fax:334-361-9945
Practice Address - Street 1:701 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-3603
Practice Address - Country:US
Practice Address - Phone:334-361-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist