Provider Demographics
NPI:1316350549
Name:RIGGIN, STEPHEN JR (RPH)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:RIGGIN
Suffix:JR
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 1:500 EASTERN AVE.
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221
Mailing Address - Country:US
Mailing Address - Phone:410-238-2607
Mailing Address - Fax:410-238-2029
Practice Address - Street 1:500 EASTERN AVE.
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221
Practice Address - Country:US
Practice Address - Phone:410-238-2607
Practice Address - Fax:410-238-2029
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist