Provider Demographics
NPI:1538205463
Name:STELTZ, SCOTT THOMAS (R PH)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:THOMAS
Last Name:STELTZ
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 S NEW MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5438
Mailing Address - Country:US
Mailing Address - Phone:484-448-2201
Mailing Address - Fax:
Practice Address - Street 1:601 UPLAND AVE SUITE 112
Practice Address - Street 2:STELTEC PHARMACY - CROZIER MILLS ENTERPRISE CENTER
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19015
Practice Address - Country:US
Practice Address - Phone:888-837-4276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10002884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP036896LOtherPHARMACIST LICENSE NUMBER
NJ28RI02143600OtherPHARMACY LICENSE
DEA10002884OtherPROFESSIONAL LICENSE