Provider Demographics
NPI:1851839500
Name:HAIR, STEPHANIE (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HAIR
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:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:NC
Mailing Address - Zip Code:28386-0466
Mailing Address - Country:US
Mailing Address - Phone:910-734-1377
Mailing Address - Fax:
Practice Address - Street 1:120 ODOM ROAD
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-0120
Practice Address - Country:US
Practice Address - Phone:910-241-6158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist