Provider Demographics
NPI:1336731363
Name:POWERS, STEFFEY O (PHARMACIST)
Entity type:Individual
Prefix:
First Name:STEFFEY
Middle Name:O
Last Name:POWERS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 875
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-0875
Mailing Address - Country:US
Mailing Address - Phone:276-393-4485
Mailing Address - Fax:
Practice Address - Street 1:116 FLANAGAN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-4514
Practice Address - Country:US
Practice Address - Phone:276-889-5721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist