Provider Demographics
NPI:1588870851
Name:BABALIS, STEVEN RUSSELL (RPH)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RUSSELL
Last Name:BABALIS
Suffix:
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:PO BOX 65
Mailing Address - Street 2:43 FEDERAL CORNER RD
Mailing Address - City:CTR. TUFTONBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03816
Mailing Address - Country:US
Mailing Address - Phone:603-569-5298
Mailing Address - Fax:
Practice Address - Street 1:891 ROUTE16
Practice Address - Street 2:
Practice Address - City:OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03864
Practice Address - Country:US
Practice Address - Phone:603-539-3898
Practice Address - Fax:603-539-9144
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR0966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist