Provider Demographics
NPI:1386922300
Name:LIONBARGER, STEPHANIE E (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:E
Last Name:LIONBARGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SPRUCE MANOR CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-9790
Mailing Address - Country:US
Mailing Address - Phone:706-372-5223
Mailing Address - Fax:
Practice Address - Street 1:140 WOODSTOCK SQUARE AVE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6500
Practice Address - Country:US
Practice Address - Phone:770-517-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist