Provider Demographics
NPI:1730362443
Name:LEIN, STEFANIE A (PHARM D)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:A
Last Name:LEIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18700 N 64TH DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7109
Mailing Address - Country:US
Mailing Address - Phone:623-362-3999
Mailing Address - Fax:
Practice Address - Street 1:18700 N 64TH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7109
Practice Address - Country:US
Practice Address - Phone:623-362-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist