Provider Demographics
NPI:1174123533
Name:TAYLOR, STEVEN CHARLES
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHARLES
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10307 ROSEDALE MILFORD CENTER RD
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:OH
Mailing Address - Zip Code:43029-9527
Mailing Address - Country:US
Mailing Address - Phone:740-506-0298
Mailing Address - Fax:
Practice Address - Street 1:10307 ROSEDALE MILFORD CENTER RD
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:OH
Practice Address - Zip Code:43029-9527
Practice Address - Country:US
Practice Address - Phone:740-506-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist