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Organization
FIRST STATE PHARMACY
Active
Organization
FIRST STATE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIE PAULUS (PRACTICE MANAGER)
(302) 766-5368
Entity
Organization
Contact information
Practice address
405 SILVERSIDE RD STE 104, WILMINGTON, DE 19809-1768
(844) 365-7246
Mailing address
223 WILMINGTON W CHESTER PIKE STE 214, CHADDS FORD, PA 19317-9007
(302) 766-5368
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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