Provider Demographics
NPI:1053946236
Name:JONES, STEPHEN PHILIP (RPH)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PHILIP
Last Name:JONES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4808 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1908
Mailing Address - Country:US
Mailing Address - Phone:402-467-1134
Mailing Address - Fax:402-467-1143
Practice Address - Street 1:4808 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1908
Practice Address - Country:US
Practice Address - Phone:402-467-1134
Practice Address - Fax:402-467-1143
Is Sole Proprietor?:No
Enumeration Date:2020-03-08
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23207183500000X
NE15691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist