Stacie Flo
Individual provider Active NPI Pharmacist · Adams, NY
NPI 1376915710 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1376915710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 062666I (NY)
- Practice address
- 10923 US Route 11
Adams, NY 13605-2109 - Phone
- (315) 232-4562
- Fax
- (315) 232-3705
- NPI assigned
- Oct 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 062666I | NY | MD | Pharmacist |
| 033.0086725 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KPH Healthcare Services, Inc. | Past | Accepting new patients | |
| KPH Healthcare Services, Inc. | Past |
Accepting new patients | |
| KPH Healthcare Services, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033.0086725 | VT | |
| Pharmacist | 183500000X | 062666I | NY | Yes |
Addresses
Primary practice location
10923 US Route 11
Adams, NY 13605-2109
Mailing address
10923 US Route 11
Adams, NY 13601
Phone (315) 232-4562
Other practice location 1
47 Executive Dr
Shelburne, VT 05482-7142
Phone (802) 985-0008 ext. 2
Other providers in Adams, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.