St Florian Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

114756 Issued in AL

Legal business name

ST FLORIAN PHARMACY INC

Practice address

4395 County Road 47
Florence, AL 35630-8998

Phone

(256) 765-0123

Fax

(256) 765-0124

NPI assigned

Aug 24, 2017

Organization subpart

No

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

Authorized official

Name

Derek Ray

Title

Owner, Pres, TCH, Ao

Phone

(256) 765-0123

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• St. Florian Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1144747700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4395 COUNTY ROAD 47",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356308998",
            "telephone_number": "256-765-0123",
            "fax_number": "256-765-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4395 COUNTY ROAD 47",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356308998",
            "telephone_number": "256-765-0123",
            "fax_number": "256-765-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST FLORIAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER, PRES, TCH, AO",
        "authorized_official_telephone_number": "256-765-0123"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171240",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Florian Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercedez Marie Speicher, ATC
• William Anthony Speyrer II, M.D.
• Brenda Lee Sprague
• SRD Florence, PLLC
• SRD Helton Drive, PLLC
• St. Florian Clinic, Inc.
• Gwen Virginia Stackhouse, CRNA
• William Ralph Stackhouse, CRNA
• Ashley Staggs
• Stevie Noel Staggs, RN

• Community/Retail Pharmacy in Florence, AL
• Providers in Florence, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.