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Individual
STEVENS M BASS
Active
Individual
STEVENS M BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28R101168900
NJ
183500000X
Pharmacist
PS18648
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28R101168900
PHARMACY LICENSE
NJ
01
—
PS18648
PHARMACY LICENSE
FL
Enumeration date
02/18/2008
Last updated
02/18/2008
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