Provider Demographics
NPI:1447667860
Name:STEEDE, HEATHER (RPH)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:STEEDE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-1027
Mailing Address - Country:US
Mailing Address - Phone:774-364-2502
Mailing Address - Fax:
Practice Address - Street 1:205 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1032
Practice Address - Country:US
Practice Address - Phone:888-820-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH20538183500000X
NH2600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist