Provider Demographics
NPI:1588976674
Name:FOSTER, STEPHEN W (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:FOSTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9219 RAMBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9506
Mailing Address - Country:US
Mailing Address - Phone:423-344-3367
Mailing Address - Fax:
Practice Address - Street 1:2289 GUNBARREL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2610
Practice Address - Country:US
Practice Address - Phone:423-892-8703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist