Stanifer Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4057 Issued in TN

Legal business name

STANIFER PHARMACY LLC

Doing business as

Stanifer Drugs

Practice address

420 N Broad St
New Tazewell, TN 37825-6606

Phone

(423) 626-7337

Fax

(423) 626-0189

NPI assigned

Dec 4, 2006

Last updated

Mar 27, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Russell EssaryNPI 1275660318

Title

Pharmacist/Owner

Phone

(423) 626-7337

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Stanifer Drugs Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Essary, PHARMD

  • Pharmacist
  • New Tazewell, TN
  • NPI 1275660318
  NPD Authorized official
• William R Stanifer Jr., DPH

  • Pharmacist
  • New Tazewell, TN
  • NPI 1124155429
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1083782221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1438",
            "city": "NEW TAZEWELL",
            "state": "TN",
            "postal_code": "378241438",
            "telephone_number": "423-626-7337",
            "fax_number": "423-626-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N BROAD ST",
            "city": "NEW TAZEWELL",
            "state": "TN",
            "postal_code": "378256606",
            "telephone_number": "423-626-7337",
            "fax_number": "423-626-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANIFER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "ESSARY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "423-626-7337"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "4057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454670",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159557",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanifer Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah Cobb Snodgrass, M.D.
• Southeastern Associated Medical Services
• Southern Allergy and Medical Clinic, Inc.
• SRH Health Inc
• Stanifer Pharmacy LLC (Stanifer Drugs, LLC)
• William R Stanifer Jr., DPH
• State of Tennessee (Claiborne County Health Department)
• Michael Allen Stephens, PA
• Heather Lynn Stumbo
• Dustin Scott Taylor, PHARMD

• Community/Retail Pharmacy in New Tazewell, TN
• Providers in New Tazewell, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.