Provider Demographics
NPI:1366786089
Name:ROLAND, STEPHANIE M (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:ROLAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 YORK ST
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-4025
Mailing Address - Country:US
Mailing Address - Phone:803-649-0521
Mailing Address - Fax:803-644-9962
Practice Address - Street 1:1041 YORK ST
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-4025
Practice Address - Country:US
Practice Address - Phone:803-649-0521
Practice Address - Fax:803-644-9962
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist