Individual
STACY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 MONUMENT RD, PHILADELPHIA, PA 19131-1600
(267) 233-5021
(215) 554-4594
Mailing address
4000 MONUMENT RD, PHILADELPHIA, PA 19131-1600
(267) 233-5021
(215) 554-4594
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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